A technical note on the posterior approach BDBO for treating Kümmell disease

Area of Science:

• Orthopedics
• Spinal Surgery
• Biomaterials

Background:

• Kümmell disease is a rare spinal disorder characterized by vertebral compression fractures and progressive kyphosis.
• Traditional treatments may have limitations in addressing both kyphosis and spinal instability.
• A combined surgical approach may offer improved outcomes for complex cases.

Purpose of the Study:

• To evaluate the therapeutic efficacy of bone-disc-bone osteotomy (BDBO) with biomimetic bone grafting and pedicle screw fixation.
• To assess surgical outcomes in patients with Kümmell disease and kyphosis.
• To analyze improvements in pain, function, spinal alignment, and neurological status.

Main Methods:

• Retrospective analysis of 22 patients with Kümmell disease and kyphosis treated with BDBO, biomimetic bone grafting, and pedicle screw implantation.
• Surgical data included operative time, blood loss, and complications.
• Patient outcomes were assessed using kyphotic Cobb angle, Visual Analog Scale (VAS), Oswestry Disability Index (ODI), and American Spinal Injury Association (ASIA) Impairment Scale.

Main Results:

• Significant improvements in VAS, ODI, and kyphotic Cobb angles were observed post-surgery and maintained at follow-up (mean 32.86 months).
• Neurological function normalized in all 8 patients with preoperative impairment.
• Achieved 100% intervertebral fusion rate with no instrumentation failures; one case of superficial incision infection resolved after debridement.

Conclusions:

• BDBO combined with biomimetic bone grafting and pedicle screw implantation is a safe and effective treatment for Kümmell disease with kyphosis.
• This surgical strategy leads to significant pain reduction, functional improvement, and spinal deformity correction.
• The procedure demonstrates high fusion rates and a low complication profile, making it a viable option for selected patients.