Analysis of the efficacy of Vesselplasty in the treatment for Kümmell′s disease / 国际外科学杂志

ABSTRACT

Objective:To compare the clinical outcomes of percutaneous vertebroplasty (PVP) and the Vesselplasty for kümmell′s disease.Methods:A retrospective case-control study was used.The clinical data of 62 patients with kümmell′s disease were selected in Beijing Friendship Hospital, Capital Medical University, from January 2017 to January 2019. There were 19 males and 43 females, aged (70.94±7.69) years, with range from 60 to 85 years. The patients were divided into two groups according to different operation methods. The 36 patients treated by PVP and 26 patients treated by Vesselplasty were followed up at least one year after operation. The follow-up time was (17.55±4.22) months. The operation time, incidence of cement leakage, preoperative and postoperative Cobb′s angle, visual analogue score (VAS) 1 week and 1 year after operation were observed. The measurement data were expressed as mean±standard deviation ( Mean± SD), independent sample t-test was used for comparison between groups. The count data were expressed as percentage (%), chi-square test was used for comparison between groups. Results:All the operation was successfully completed. No serious complications such as paraplegia, bone cement allergy, pulmonary embolism were occurred. The operation time was no significant difference between the two groups ( P< 0.05). The incidence of cement leakag was 41.67% (15/36) in PVP group and 11.54% (3/26) in Vesselplasty group. The latter was significantly lower than the former, with statistically significant differences between the two groups ( P< 0.05). In PVP group, the Cobb′s angles of preoperation, postoperation 1 year and difference were (26.23 ± 5.62)°, (17.46 ± 3.01)° and (8.78 ± 4.62)°, respectively, in Vesselplasty group, they were (28.74 ± 6.68)°, (16.68 ± 2.79)° and (12.07 ± 5.72)°, respectively. Cobb′s angle of the two groups was significantly improved after operation. In the comparison between the groups, the improvement of the Cobb′s angle in the Vesseplasty group was better than that of the PVP group, and the difference was statistically significant ( P< 0.05). The VAS score in PVP group was (8.42±1.03) scores in preoperation, (3.06±1.01) scores in 1 week, (0.81±0.75) scores in 1 year. The VAS score in Vesselplasty group was (8.35±1.02) scores in preoperation, (2.88±1.11) scores in 1 week and (1.04±0.87) scores in 1 year. Compared with pre-operation, the VAS scores of the two groups decreased significantly at 1 week and 1 year after operation, and the difference was statistically significant ( P<0.05). There was no significant difference in VAS between groups 1 week after operation and 1 year after operation ( P>0.05). Conclusion:Vesselplasty can effectively control the flow and distribution of bone cement in the vertebral body, effectively reduce the leakage of bone cement, and better correct kyphosis.