Hollow Screw Placement Combined with Percutaneous Vertebroplasty Serves as a Valuable Three-Column Intensive Treatment for Patients with Kummell's Disease and Pedicle Rupture.

ABSTRACT

Purpose: To introduce the surgical methods and clinical results of percutaneous vertebroplasty (PVP) combined with hollow screw placement as a treatment for patients with Kummell's disease and pedicle rupture. Methods: From January 2020 to January 2023, a total of 10 patients with Kummell's disease and pedicle rupture confirmed via imaging underwent three-column intensive therapy using hollow screws combined with PVP. There were two males and eight females with an average age 75.7±6.11 years old. The time of operation, bone cement injection amount, bone cement leakage during operation were recorded. X-ray and CT were reexamined after operation. The improvement in quality of life was assessed using the Oswestry Disability Index (ODI), and the improvement in low back pain was assessed using the visual analogue scale (VAS). Results: Hollow screw placement combined with PVP was successfully performed in all patients. The average operation time was 39.2±5.1 min, and the average volume of bone cement injected was 5.85±0.83mL. No leakage of bone cement into spinal canal occurred.The mean preoperative ODI score was 75.70±4.39, but this decreased significantly postoperatively(P<0.05), being 37.70±6.95 at 1 day and 26.40±4.90, 23.70±4.87, 21.70±5.46, and 20.50±4.21 at 1, 3, 6, and 12 months after the operation, respectively. The mean VAS pain score before the operation was 8.35±0.63, but the symptoms of back pain were significantly relieved after operation(P<0.05). The mean VAS scores 1 day and 1, 3, 6, and 12 months after the operation were 3.45±0.47, 2.55±0.60, 1.89±0.48, 1.50±0.27, and 1.12±0.20, respectively. Conclusion: Hollow screw placement combined with percutaneous vertebroplasty serves as a valuable three-column intensive treatment for patients with Kummell's disease and pedicle rupture. This procedure has the advantages of minimal trauma, less pain and quick recovery. The strong anchoring of bone cement and hollow screws provides stable and firm healing conditions for vertebral and pedicle fractures.