Short-Segment Fixation With Bone Cement Augmentation for Unstable Kümmell Disease: A Minimum 2-Year Follow-Up Study

A retrospective study.

To explore the efficacy of short-segment fixation with bone cement augmentation in the treatment of unstable Kümmell disease.

Kümmell disease, characterized by delayed post-traumatic osteonecrosis of the vertebral body, often results in progressive vertebral collapse and instability, posing challenges for surgical management. Bone cement augmentation combined with short-segment fixation has emerged as a potential solution, but its long-term efficacy and safety require further evaluation.

From January 2017 to June 2022, retrospective study was conducted on the clinical data of patients with single-segment unstable Kümmell disease. A total of 45 cases unstable Kümmell disease patients with an average age of 71.4±6.0 years were included. The disease duration was 23.1±8.1 months. The bone mineral density (BMD) T-value was -3.5±0.4 SD. Each patient was treated with short-segment fixation with bone cement augmentation and posterolateral bone graft fusion. Evaluation outcomes include the visual analog scale (VAS), Oswestry disability index (ODI), anterior vertebral height, kyphosis Cobb angle.

The operation time was 116.0±21.7 minutes, the intraoperative blood loss was 156.2±54.8 mL. All patients were followed-up for an average of 36.6±8.7 months. Compared with preoperative, VAS, ODI, and kyphosis Cobb angle were significantly decreased postoperative (P<0.05), and anterior vertebral height was significantly increased postoperative (P<0.05). Compared with postoperative, VAS, ODI were significantly decreased last follow-up (P<0.05), and anterior vertebral height, kyphosis Cobb angle was were not significantly changed last follow-up (P<0.05). At the last follow-up, all patients fixed segments were fused. There was no failure of internal fixation during the follow-up.

Short-segment fixation with bone cement augmentation in the treatment of unstable Kümmell disease is feasible and effective, can improve the clinical symptoms of patients, better correct kyphosis, and maintain the height of the injured vertebra, with fewer complications.