Bone Cement-Augmented Percutaneous Short Segment Fixation : An Effective Treatment for Kummell's Disease?

Objective : The aim of this prospective study was to evaluate the efficacy of bone cement-augmented percutaneous short segment fixation for treating Kummell's disease accompanied by severe osteoporosis. Methods : From 2009 to 2013, ten patients with single-level Kummell's disease accompanied by severe osteoporosis were enrolled in this study. After postural reduction for 1-2 days, bone cement-augmented percutaneous short segment fixation was performed at one level above, one level below, and at the collapsed vertebra. Clinical results, radiological parameters, and related complications were assessed preoperatively and at 1 month and 12 months after surgery. Results : Prior to surgery, the mean pain score on the visual analogue scale was $8.5{\pm}1.5$. One month after the procedure, this score improved to $2.2{\pm}2.0$ and the improvement was maintained at 12 months after surgery. The mean preoperative vertebral height loss was $48.2{\pm}10.5%$, and the surgical procedure reduced this loss to $22.5{\pm}12.4%$. In spite of some recurrent height loss, significant improvement was achieved at 12 months after surgery compared to preoperative values. The kyphotic angle improved significantly from $22.4{\pm}4.9^{\circ}$ before the procedure to $10.1{\pm}3.8^{\circ}$ after surgery and the improved angle was maintained at 12 months after surgery despite a slight correction loss. No patient sustained adjacent fractures after bone cement-augmented percutaneous short segment fixation during the follow-up period. Asymptomatic cement leakage into the paravertebral area was observed in one patient, but no major complications were seen. Conclusion : Bone cement-augmented percutaneous short segment fixation can be an effective and safe procedure for Kummell's disease.