Efficacy and Safety of Vertebroplasty with Cement Anchoring Technique for Stage II Kümmell’s Disease: A Retrospective Cohort Study

Background In Kummell's Disease (KD), stage II patients frequently present with vertebral pseudarthrosis. The associated sclerotic changes at the margins of the pseudarthrosis can hinder the restoration of vertebral height and adversely affect cement distribution and therapeutic outcomes. To evaluate the efficacy of the cement anchoring technique (CAT) in the treatment of stage II KD. Methods A total of 71 patients (CAT group: 33 cases, PVP group: 38 cases) were enrolled between January 2020 and June 2024. The following parameters were compared between two groups: gender, age, BMI, lumbar BMD, duration of disease, fracture type, compression ratio, operative time, volume of cement injected, incidence of cement leakage, cement distribution and pattern, VAS, anterior vertebral height (AVH), middle vertebral height (MVH), posterior vertebral height (PVH), Cobb angle preoperatively and at 1 month and 1 year postoperatively, and ODI preoperatively and at 3 months and 1 year postoperatively. Results All procedures were completed successfully without serious complications. CAT group had more cement injected (5.73 ± 1.32ml / 4.92 ± 0.91ml, P < 0.05) and lower cement leakage (27.27% / 52.63%, P < 0.05) than PVP group. The spongy distribution pattern (63.63% / 28.95%, P < 0.05) and satisfactory cement distribution (57.57% / 36.84%, P < 0.05) was higher in the CAT group. Postoperative VAS and ODI scores improved significantly in two groups. Nevertheless, the postoperative improvement in CAT group was better (P < 0.05). For AVH, MVH, and Cobb angle, the CAT group exhibited significantly greater improvements at 1 month and 1 year postoperatively(P < 0.05). PVP group showed significant deterioration in these parameters at 1 year compared with the 1-month assessment (P < 0.05). Conclusion Cement anchoring technique is a safer and more effective alternative for treating stage II KD. It effectively alleviates pain symptom, promotes better cement diffusion, prevents cement leakage, and effectively improve and maintain vertebral height and reduced kyphotic deformity.