Clinical Report: Guiding Surgical Choices in Stage III Kümmell Disease

Overview

This study compares the outcomes of percutaneous kyphoplasty (PKP) and short-segment fixation with vertebroplasty (SSF+VP) in patients with stage III Kümmell disease without neurological deficits, focusing on operative time, blood loss, hospital stay, and pain outcomes as measured by VAS scores.

Background

Kümmell disease (KD) is an osteonecrotic disorder of the vertebral body, primarily affecting elderly patients with osteoporosis. Stage III KD is characterized by significant vertebral collapse and kyphotic deformity, presenting challenges in surgical management. Understanding optimal surgical strategies is crucial for effective pain relief and prevention of long-term complications.

Data Highlights

Key Findings

• PKP resulted in shorter operative time and less blood loss compared to SSF+VP.
• SSF+VP achieved lower postoperative and final Cobb angles with less Cobb angle loss.
• In the PKP group, Cobb angle loss was positively correlated with final VAS scores.
• The optimal preoperative Cobb angle cut-off for predicting residual pain after PKP was identified as 25.95°.
• SSF+VP showed better intermediate-term pain outcomes in patients with severe kyphosis.

Clinical Implications

Preoperative Cobb angle assessment can aid in surgical decision-making for patients with stage III KD.

Conclusion

Both PKP and SSF+VP improved pain and function in stage III KD without neurological deficits.

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