Clinical observation of two bone cement distribution modes of percutaneous vertebroplasty in the treatment of thoracolumbar Kümmell’s disease
Authors: Chen Ji-Bin , Xiao Ya-Ping , Chen Dong , Chang Jian-Zhong , Li Te 
Published: April 2020

Abstract
Background
In recent years, percutaneous vertebroplasty (PVP) has provided a new option for the treatment of Kümmell’s disease (KD). The purpose of this study is to study the differences in clinical characteristics, clinical efficacy and related complications between two types of bone cement distribution patterns in the PVP treatment of KD.
Methods
Retrospective analysis from January 2016 to February 2018 showed that 63 patients with KD who received PVP treatment were included in the study. According to X-ray distribution modes of bone cement after treatment, all patients were divided into blocky group (30 cases ) and spongy group (33 cases). Clinical features and disease severity Preoperatively of the two groups, and clinical efficacy and related complications postoperatively were compared between the two groups.
Results
There was no significant difference in gender, injured segment, VAS and ODI preoperatively between the two groups (all P > 0.05). The duration of disease, age, Cobb angle and vertebral compression rate preoperatively were significantly higher in the blocky group than in the spongy group (P < 0.05, respectively). The height of vertebral anterior margin and BMD were significantly lower in the blocky group than in the spongy group (P < 0.05, respectively). The two groups were followed for at least 24 months. There were no statistically differences in the follow-up time, operation time, intraoperative blood loss, number of fluoroscopy, bone cement leakage and adjacent vertebral fracture between the two groups (all P > 0.05). The amount of bone cement injected into the blocky group was significantly higher than that of the spongy group (P = 0.000). VAS score and ODI postoperatively of the two groups were significantly reduced at 1 day, 1 year and the last follow-up (all P = 0.000), and were maintained at the last follow-up. VAS score and ODI postoperatively decreased significantly in the spongy group compared with the blocky group (P = 0.000). The correction degrees of kyphosis and vertebral compression postoperatively in the two groups were significantly corrected, but gradually decreased over time (P < 0.05), and these correction degrees of the blocky group was significantly higher than that of the spongy group and the postoperative loss was also more serious.
Conclusions
The treatment of KD by PVP can effectively relieve pain, improve function, restore vertebral height and correct kyphosis. The disease in the blocky group was more serious than that in the spongy group. The amount of bone cement, correction degrees of postoperative kyphosis and vertebral compression were significantly higher in the blocky group than in the spongy group, but the postoperative loss was also more serious in the blocky group. However, for pain relief and functional recovery, the spongy group was superior to the blocky group. Therefore, the spongy distribution pattern should be formed during the injection of bone cement to obtain better therapeutic effect.