4.4 Article

Bone Cement Reperfusion Revision Surgery for Symptomatic Recurrence of Kummell's Disease After Percutaneous Kyphoplasty

Journal

GLOBAL SPINE JOURNAL
Volume -, Issue -, Pages -

Publisher

SAGE PUBLICATIONS LTD
DOI: 10.1177/21925682231174189

Keywords

bone cement reperfusion; kummell's disease; percutaneous kyphoplasty; repeat percutaneous vertebroplasty; symptomatic recurrence; cemented vertebral nonunion

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This study aims to demonstrate the therapeutic benefit of repeat Percutaneous Vertebroplasty (PVP) in Kummell's disease patients with recurrent symptoms after initial Percutaneous Kyphoplasty (PKP) treatment. The results show that repeat PVP can ameliorate kyphosis and restore vertebral height to some extent, providing superior long-term outcomes in clinical and radiological aspects.
Study Design Retrospective study. Objectives To demonstrate that repeat Percutaneous vertebroplasty (PVP) performed for the same cemented vertebrae in Kummell's disease can offer therapeutic benefit for patients with recurrent symptoms after initial percutaneous kyphoplasty (PKP) treatment. Methods From January 2019 to December 2021, we investigated 2932 patients with PKP. Among them, 191 patients were diagnosed Kummell's disease. 33 patients upon presentation of recurrent symptoms underwent repeat PVP procedure. Radiologic outcomes and clinic indices were investigated. Results Bone cement reperfusion surgery was successfully completed in 33 patients. The average age was 73.5 +/- 8.2 years old. The kyphosis angle showed significant correction from pre-operation to the final follow-up, descending from pre-operation (20.6 +/- 11.1 degrees) to final follow-up (15.4 +/- 7.9 degrees). The vertebral heights at different follow-up appointments were significantly higher than the pre-operative appointments. The VAS and ODI scores at final follow-up were respectively 1.2 +/- .8 and 27.3 +/- 5.4%, which were both significantly lower than those before operation. No complications such as cement leakage into the spinal canal or cement displacement occurred during follow-up. Conclusions Bone cement reperfusion surgery can ameliorate kyphosis and restore vertebral height to some extent. Repeat PVP is a minimally invasive surgery that provides superior long-term results in clinical and radiological outcomes but is technically more difficult to perform.

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