The use of spiral cement injector for percutaneous vertebroplasty to treat Kümmell's disease : A retrospective study.

BACKGROUND: Percutaneous vertebroplasty (PVP) is a common method used to treat Kümmell's disease. In the patients without neurological symptoms, we sought to evaluate whether using the new spiral injectors instead of the traditional push rod injectors in PVP can result in improved clinical efficacy for the treatment of Kümmell's disease.

METHODS: This was a clinical, retrospective study conducted between August 2018 and December 2020. The study included patients diagnosed with single-level thoracolumbar Kümmell's disease who underwent PVP surgery. The patients were divided into two groups: an observation group consisting of 53 cases treated with spiral injectors, and the control group consisting of 68 cases treated with pushrod injectors.

RESULTS: A 2-year follow-up period was carried out. The bone cement injection volume and occurrence of bone cement leakage were significantly greater in the observation group compared to the control group (P<0.05). The observation group had significantly shorter operation time and intraoperative fluoroscopy times compared to the control group (P<0.05). The scores for VAS and ODI in both groups were significantly lower at 3 days or 3 months and 2 years post-surgery compared to pre-surgery, with the scores at 2 years post-surgery being significantly lower than those at 3 days or 3 months for both groups (P<0.05). The relative anterior ledge height and Cobb angle showed significant improvement at 3 days and 2 years after surgery compared to pre-surgery in both groups (P<0.05), but cases in the observation group experienced substantial improvement at 3 days and 2 years post-surgery compared to those in the control group (P<0.05). In both groups, the relative anterior ledge height was noticeably lower 2 years post-surgery compared to 3 days post-surgery (P<0.05). Concurrently, there was a significant increase in the local Cobb angle over time in both groups (P<0.05).

CONCLUSIONS: The implementation of both spiral injector and traditional push rod injector in PVP surgery yields effective pain relief, improved function, partially restored vertebral height, and corrected kyphosis in treating Kümmell's disease. Compared to the push rod injector, the spiral injector is highly efficient in restoring vertebral height, correcting kyphosis, minimizing fluoroscopy usage and operation time, but it carries a greater risk of bone cement leakage.