Ultrasonography-guided canal decompression combined with vertebroplasty and cement-augmented pedicle screw fixation for stage III Kümmell's disease with neurological deficits: a retrospective cohort study.

Autor: Zhang C; Department of Spine Surgery, The Second Hospital of Shandong University, 247 Beiyuan Road, Jinan, 250033, Shandong, China., Zhao Y; Department of Spine Surgery, The Second Hospital of Shandong University, 247 Beiyuan Road, Jinan, 250033, Shandong, China., Li Q; Department of Orthopaedic Surgery, Yishui County People's Hospital, 2 Zhengyang Road, Linyi, 276400, Shandong, China., Xu W; Department of Spine Surgery, The Second Hospital of Shandong University, 247 Beiyuan Road, Jinan, 250033, Shandong, China., Dou C; Department of Spine Surgery, The Second Hospital of Shandong University, 247 Beiyuan Road, Jinan, 250033, Shandong, China., Cao G; Department of Spine Surgery, The Second Hospital of Shandong University, 247 Beiyuan Road, Jinan, 250033, Shandong, China., Wu D; Department of Spine Surgery, The Second Hospital of Shandong University, 247 Beiyuan Road, Jinan, 250033, Shandong, China. 15153169657@163.com., Zhao J; Department of Spine Surgery, The Second Hospital of Shandong University, 247 Beiyuan Road, Jinan, 250033, Shandong, China. sdeyzj2019@163.com.
Jazyk: angličtina
Zdroj: BMC musculoskeletal disorders [BMC Musculoskelet Disord] 2024 Oct 12; Vol. 25 (1), pp. 805. Date of Electronic Publication: 2024 Oct 12.
DOI: 10.1186/s12891-024-07929-6
Abstrakt: Background: Percutaneous vertebroplasty or kyphoplasty is the preferred procedure for stage I and II Kümmell's diseases (KDs), but there exist controversies on the operative option of stage III KD. This study aimed at exploring the safety and efficacy of ultrasonography-guided canal decompression (UG-CD) combined with vertebroplasty and cement-augmented pedicle screw fixation (CA-PSF) for treating stage III KD with neurological deficit (ND).
Methods: Between September 2017 and December 2023, all patients who received the UG-CD combined with vertebroplasty and CA-PSF for managing stage III KD with NDs were reviewed retrospectively with their demographic and operation data, and complications recorded. Besides, the scores of Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI), together with imaging data including the kyphotic Cobb angle (KCA), wedge angle (WA), spinal canal area (SCA) at the narrowest level as well as anterior (AHR) and middle (MHR) height ratios were measured and compared between pre- and post-operation.
Results: A total of eleven patients with a mean age of 70.09 ± 2.98 years old were included in our study with their surgical time, hospitalization length, blood loss, and follow-up time being 150.91 ± 17.94 min, 202.09 ± 39.95 ml, 8.18 ± 1.17 days, and 16.91 ± 4.09 months, respectively. During the final follow-up, the KCA, WA, VAS scores, ODI scores, AHR, MHR, and SCA were significantly improved (P < 0.01). Intraoperatively, one case suffered a transient decrease in the motor evoked potential. Another case experienced a cerebrospinal fluid leakage postoperatively that was then successfully treated.
Conclusion: UG-CD combined with vertebroplasty and CA-PSF could be a feasible procedure for safely and effectively handling stage III KD with NDs.
(© 2024. The Author(s).)
Databáze: MEDLINE
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