Analysis of strategy and efficacy clinical treatments of Kümmell disease: a cohort study

• Published in: Annals of translational medicine 2022-09, Vol.10 (18), p.974-974
• Main Authors: Xu, Weixing, Ding, Weiguo, Xu, Xinwei, Sheng, Hongfeng, Zhu, Jiafu, Xin, Long, Xu, Bin
• Format: Article
• Language: English
• Subjects: Original
• ISSN: 2305-5839; 2305-5839
• DOI: 10.21037/atm-22-3801

BackgroundMost clinical reports on the surgical treatment of kümmell disease lack consistency between classification and treatment protocol. In this study, we investigate the most appropriate and effective clinical treatment strategies according to the characteristics of different types of Kümmell disease. MethodsA retrospective analysis was performed of 48 patients with Kümmell disease treated in Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China for which complete follow-up data were available. All cases were classified into six types: type I, vertebral body height loss less than 20% and no intervertebral disc degeneration from adjacent segments; type II, vertebral body height loss more than 20% and accompanied by degeneration or mild instability of intervertebral discs at adjacent segments; type III, posterior vertebral cortical rupture and dural sac compression, and some accompanied by spinal cord nerve injury. Type III includes type IIIA (recoverable stable type), type IIIB (recoverable unstable type), type IIIC (spinal stenosis type), and type IIID (kyphosis type). Methods of surgery: patients of types I, II, and IIIA were treated with percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP), type IIIB were treated with posterior fixation and fusion, type IIIC were treated with posterior decompression and fixation fusion, and type IIID were treated with posterior osteotomy, orthopedic fixation, and fusion. All patients were followed up for 10-44 months (mean, 20.5±4.5 months). The preoperative and postoperative visual analog scale (VAS) scores, Owestry disability index (ODI) scores, secondary height loss and kyphosis, and neurological improvement were followed up and statistically analyzed. ResultsThe VAS and ODI scores of all cases were improved compared with those pre-surgery (P