Posterior decompression and short segmental pedicle screw fixation combined with vertebroplasty for Kümmell's disease with neurological deficits

Zhang,Guang-Quan; Gao,Yan-Zheng; Zheng,Jia; Luo,Jian-Ping; Tang,Chao; Chen,Shu-Lian; Wang,Hong-Qiang; Liu,Ke; Xie,Rui-Gang

doi:10.3892/etm.2012.833

February 2013 Volume 5 Issue 2

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February 2013 Volume 5 Issue 2

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Article

Posterior decompression and short segmental pedicle screw fixation combined with vertebroplasty for Kümmell's disease with neurological deficits

Authors:
- Guang-Quan Zhang
- Yan-Zheng Gao
- Jia Zheng
- Jian-Ping Luo
- Chao Tang
- Shu-Lian Chen
- Hong-Qiang Wang
- Ke Liu
- Rui-Gang Xie
View Affiliations / Copyright

Affiliations: Department of Orthopedics, Henan Province People's Hospital, Zhengzhou, Henan 450003, P.R. China, Department of Orthopedics, Henan Province People's Hospital, Zhengzhou, Henan 450003, P.R. China, Department of Radiology, Henan Province People's Hospital, Zhengzhou, Henan 450003, P.R. China
Pages: 517-522
|
Published online on: November 26, 2012

https://doi.org/10.3892/etm.2012.833
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Abstract

The aim of this study was to investigate the treatment of Kümmell's disease with neurological deficits and to determine whether intravertebral clefts are a pathognomonic sign of Kümmell's disease. A total of 17 patients who had initially been diagnosed with Kümmell's disease were admitted, one patient was excluded from this study. Posterior decompression and vertebroplasty for the affected vertebrae were conducted. Pedicle screw fixation and posterolateral bone grafts were performed one level above and one level below the affected vertebrae. Vertebral tissue was extracted for histopathological examination. The mean time of follow‑up was 22 months (range, 18 to 42 months). The anterior and middle vertebral heights were measured on standing lateral radiographs prior to surgery, one day postoperatively and at final follow‑up. The Cobb angle, the visual analog scale (VAS) and the Frankel classification were used to evaluate the effects of the surgery. The VAS, anterior and middle vertebral heights and the Cobb angle were improved significantly one day postoperatively and at the final follow-up compared with the preoperative examinations (P<0.05). No significant differences were observed between the one-day postoperative results and those at final follow-up (P>0.05). The neurological function of all patients was improved by at least one Frankel grade. All patients in this study exhibited intravertebral clefts, and postoperative pathology revealed bone necrosis. One patient (not included in this study) showed an intravertebral cleft, but the pathology report indicated a non-Hodgkin's lymphoma. The intravertebral cleft sign is not pathognomonic of Kümmell's disease. Posterior decompression with short-segment fixation and fusion combined with vertebroplasty is an effective treatment for Kümmell's disease with neurological deficits.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Posterior decompression and short segmental pedicle screw fixation combined with vertebroplasty for Kümmell's disease with neurological deficits

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