Percutaneous vertebroplasty versus percutaneous kyphoplasty in treating Kummell disease of peripheral sclerosis type in stage Ⅲ

  Objective  To compare the clinical efficacy of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in the treatment of patients with Kummell disease of peripheral sclerosis type in stage Ⅲ.

  Methods  The clinical materials of 77 patients with peripheral sclerosis type of Kummell disease in stage Ⅲ were retrospectively analyzed. Among them, 11 patients treated with PVP were selected as PVP group, and 66 patients treated with PKP were selected as PKP group. The operation time, the injected amount of bone cement, the Visual Analogue Scale (VAS) of pain and Oswestry dysfunction index (ODI) before operation, 1 day after operation and at the last follow-up, the height of the anterior edge of the vertebral body and the local Cobb angle of the diseased vertebral body were compared between the two groups.

  Results  Patients in both groups completed the operation successfully and were followed up. The PVP group was followed up for 16.00 (14.50, 18.00) months, and the PKP group was followed up for 16.00 (14.00, 18.00) months. The intraoperative injected volume of bone cement was 3.00 (2.00, 3.00) mL in the PVP group and 4.00 (4.00, 5.00) mL in the PKP group, and there was a significant difference between two groups (Z=-4.63, P < 0.01); the operation time was 30.00 (27.00, 33.00) min in the PVP group and 50.00 (45.00, 57.00) min in the PKP group, and there was also a significant difference between two groups (Z=-4.91, P < 0.01). One day after operation and at the last follow-up, the VAS score and ODI in both groups were significantly lower than those before operation in the same group (P < 0.01). One day after operation and at the last follow-up, the vertebral body height in both groups were higher than that before operation in the same group, and the Cobb angle was significantly lower than that before operation; meanwhile, the vertebral body height of the PKP group was higher than that of the PVP group, and the Cobb angle was smaller than that of the PVP group; the differences above were statistically significant (P < 0.05 or P < 0.01).

  Conclusion  Both PVP and PKP can effectively alleviate the intractable pain in the lower back of patients with peripheral sclerosis type of Kummell disease in stage Ⅲ, but PKP can better restore the height of vertebral body and improve local kyphosis.