Combine Short-Segment Fixation and Leverage Reduction Technique to Correct Kyphotic Angle in Kümmell's Disease

Kümmell disease is a prevalent spinal condition characterized by vertebral fractures and subsequent spinal nerve injury, significantly impacting patients' quality of life and imposing a considerable economic burden on society. Current treatment modalities, including percutaneous vertebroplasty (PVP) and kyphoplasty (PKP), often fail to alleviate symptoms or restore vertebral height in advanced stages of the disease, highlighting the urgent need for improved surgical interventions. This study aims to evaluate the surgical outcomes of short-segment fixation combined with leverage reduction technique in patients with Kümmell disease accompanied by kyphosis deformity.

A retrospective analysis was conducted on 22 patients who were treated with short-segment fixation and leverage reduction technique between 2020 and 2023. Clinical evaluation, including operation time, blood loss volume, and postoperative complications, were collected. The visual analog scale (VAS) score for pain and Frankel classification were used to evaluate the patients' functional outcome. The radiographic analysis included local kyphotic angle (LKA), regional kyphotic angle (RKA), anterior vertebral height (AVH), posterior vertebral height (PVH), and sagittal compression (SC). The student t-test and the χ²-test (or the Fisher exact test) were used to compare the outcome measures between the preoperative group and postoperative group.

The results demonstrate that the surgical technique led to limited intro-operative blood loss (average 85.7 ± 29.4 mL) and short surgery duration (average 100.1 ± 36.3 min), and significantly improved pain status postoperatively (p < 0.05). Average vertebral height restoration reached 83% ± 14% of predicted normal height, with mean kyphotic angle correction of 19.32° ± 6.27°. Notably, the proportion of patients classified as Frankel grade D and E improved significantly at the last follow-up (p < 0.05), indicating favorable neurological recovery. Although there was an instance of cement leakage, no severe complications such as internal fixation failure or neurological damage occurred.

The results suggest that short-segment fixation combined with leverage reduction technique is a promising surgical strategy for patients with Kümmell disease and kyphosis deformity, effectively alleviating pain, restoring vertebral height, and promoting neurological recovery.