Kummell disease: bone cement leakage during kyphoplasty

doi:10.3969/j.issn.2095-4344.0691

Abstract

Abstract:

BACKGROUND: Kummell disease has certain correlation with osteoporotic vertebral fracture morphology and magnetic resonance imaging manifestations; however, few reports focus on the correlation between the severity of osteoporotic vertebral fracture and Kummell disease.

OBJECTIVE: To analyze the correlation between Genant classification and Kummell disease in osteoporotic vertebral fractures, and to investigate the prevention and treatment of bone cement complications during percutaneous kyphoplasty for the treatment of Kummell disease.

METHODS: Eighty-four elderly patients with osteoporotic vertebral compression fractures undergoing conservative treatment were selected. A total of 109 cases of vertebral bodies were involved. The T₉-L₄ vertebral body segments were involved in fractures. Fracture vertebral bodies were graded according to the Genant semi-quantitative assessment method (48 cases of mild malformation, 34 cases of moderate malformation, and 27 cases of severe malformation). After 6 months of conservative treatment, they were referred again. MRI imaging was performed to observe the occurrence of fractured vertebral body segmental cleft, to determine Kummell disease, and to assess the severity of disease (type I, II, III). For patients diagnosed with Kummell disease, kyphoplasty with bone cement was performed. The bone cement leakage was observed by X-ray. The pain, lumbar back function, height of anterior vertebral body and recovery of Cobb angle were observed after treatment.

RESULTS AND CONCLUSION: (1) Of the 184 patients, intervertebral vacuum cleft sign was found in 23 cases (mostly in the T₁₂ segment), and its incidence with mild, moderate, and severe malformations was 3%, 6%, and 12%, respectively. (2) After kyphoplasty with bone cement, 1 case of intervertebral disc leakage and 1 case of paravertebral leakage were found in the 6 cases of type I Kummell disease; 2 cases of cemented intervertebral disc leakage and 1 case of paravertebral leakage were found in the 14 cases of type II Kummell disease; and 1 case of cemented intervertebral disc leakage and 1 case of paravertebral leakage were found in the 3 cases of type III Kummell disease. There was no difference in the incidence of intervertebral disc leakage and paravertebral leakage between different subtypes. (3) The pain, lumbar back function, anterior vertebral height and Cobb angle were significantly improved in 23 patients with Kummell disease at the 6-month follow-up (P < 0.05). These results reveal that with the increasing of Genant grading, the incidence of Kummell disease increases. The rate of bone cement leakage after kyphoplasty for Kummell disease is at a high level, and intradiscal leakage tends to occur in most cases.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

Key words: Kyphoplasty, Osteoporosis, Fractures, Compression, Tissue Engineering

CLC Number:

R459.9

Lu Wenchao, Wang Yupeng, Zhan Chuan. Kummell disease: bone cement leakage during kyphoplasty[J]. Chinese Journal of Tissue Engineering Research, 2019, 23(2): 172-177.

Figures/Tables 6

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