Skip to main content
SpringerLink
Log in

Comparison of percutaneous vertebroplasty and percutaneous kyphoplasty for the management of Kümmell’s disease

A retrospective study

  • Original Article
  • Published:
Indian Journal of Orthopaedics Aims and scope Submit manuscript

Abstract

Background

Post traumatic osteonecrosis of a vertebral body occurring in a delayed fashion was first described by the German doctor Kümmell in 1895. Several studies have reported percutaneous vertebroplasty (PVP), or percutaneous kyphoplasty (PKP) for Kümmell’s disease achieves good outcomes. However, it is unknown whether a technique is superior for the treatment of this disease. The objective of the study is to compare the efficacy of PVP and PKP for the treatment of Kümmell’s disease.

Materials and Methods

A retrospective review was conducted for 73 patients with Kümmell’s disease. PVP was performed in 38 patients and PKP in 35 patients. Visual analogue score (VAS) was used to evaluate pain. The anterior vertebral height was measured. The operative time, the incidence of cement leakage and the costs were recorded.

Results

In both PVP group and PKP group, the VAS and anterior vertebral height significantly improved at 1–day postoperatively (P < 0.05), and the improvement sustained at the final followup (P > 0.05). Between the PVP and PKP groups, there were no significant differences in VAS and the anterior vertebral height at 1–day postoperatively and at the final followup (P > 0.05). The operating time and expense in the PKP group were higher than the PVP group (P < 0.001). Cement leakages in the PKP group were fewer than PVP group (P < 0.05).

Conclusions

PVP is a faster, less expensive option that still provides a comparable pain relief and restoration of vertebral height to PKP for the treatment of Kümmell’s disease. PKP has a significant advantage over PVP in term of the fewer cement leakages.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Maldague BE, Noel HM, Malghem JJ. The intravertebral vacuum cleft: A sign of ischemic vertebral collapse. Radiology 1978;129:23–9.

    Article  CAS  PubMed  Google Scholar 

  2. Malghem J, Maldague B, Labaisse MA, Dooms G, Duprez T, Devogelaer JP, et al. Intravertebral vacuum cleft: Changes in content after supine positioning. Radiology 1993;187:483–7.

    Article  CAS  PubMed  Google Scholar 

  3. Bhalla S, Reinus WR. The linear intravertebral vacuum: A sign of benign vertebral collapse. AJR Am J Roentgenol 1998;170:1563–9.

    Article  CAS  PubMed  Google Scholar 

  4. Libicher M, Appelt A, Berger I, Baier M, Meeder PJ, Grafe I, et al. The intravertebral vacuum phenomen as specific sign of osteonecrosis in vertebral compression fractures: Results from a radiological and histological study. Eur Radiol 2007;17:2248–52.

    Article  PubMed  Google Scholar 

  5. Feng SW, Chang MC, Wu HT, Yu JK, Wang ST, Liu CL. Are intravertebral vacuum phenomena benign lesions? Eur Spine J 2011;20:1341–8.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Zhang GQ, Gao YZ, Zheng J, Luo JP, Tang C, Chen SL, et al. Posterior decompression and short segmental pedicle screw fixation combined with vertebroplasty for Kümmell’s disease with neurological deficits. Exp Ther Med 2013;5:517–22.

    Article  PubMed  Google Scholar 

  7. Jang JS, Kim DY, Lee SH. Efficacy of percutaneous vertebroplasty in the treatment of intravertebral pseudarthrosis associated with noninfected avascular necrosis of the vertebral body. Spine (Phila Pa 1976) 2003;28:1588–92.

    Google Scholar 

  8. Do HM, Jensen ME, Marx WF, Kallmes DF. Percutaneous vertebroplasty in vertebral osteonecrosis (Kummell’s spondylitis). Neurosurg Focus 1999;7:e2.

    Article  CAS  PubMed  Google Scholar 

  9. Becker S, Tuschel A, Chavanne A, Meissner J, Ogon M. Balloon kyphoplasty for vertebra plana with or without osteonecrosis. J Orthop Surg (Hong Kong) 2008;16:14–9.

    Article  CAS  Google Scholar 

  10. Yang H, Gan M, Zou J, Mei X, Shen X, Wang G, et al. Kyphoplasty for the treatment of Kümmell’s disease. Orthopedics 2010;33:479.

    PubMed  Google Scholar 

  11. Kümmell H. Die rarefizierende Ostitis der Wirbelkrper. Dtsch Med 1985;21:180–1.

    Article  Google Scholar 

  12. Theodorou DJ. The intravertebral vacuum cleft sign. Radiology 2001;221:787–8.

    Article  CAS  PubMed  Google Scholar 

  13. Peh WC, Gelbart MS, Gilula LA, Peck DD. Percutaneous vertebroplasty: Treatment of painful vertebral compression fractures with intraosseous vacuum phenomena. AJR Am J Roentgenol 2003;180:1411–7.

    Article  PubMed  Google Scholar 

  14. Mirovsky Y, Anekstein Y, Shalmon E, Peer A. Vacuum clefts of the vertebral bodies. AJNR Am J Neuroradiol 2005;26:1634–40.

    PubMed  PubMed Central  Google Scholar 

  15. Lee SH, Cho DC, Sung JK. Catastrophic intramedullary hematoma following Kümmell’s disease with large intravertebral cleft. Spine J 2008;8:1007–10.

    Article  PubMed  Google Scholar 

  16. Lane JI, Maus TP, Wald JT, Thielen KR, Bobra S, Luetmer PH. Intravertebral clefts opacified during vertebroplasty: Pathogenesis, technical implications, and prognostic significance. AJNR Am J Neuroradiol 2002;23:1642–6.

    PubMed  PubMed Central  Google Scholar 

  17. McKiernan F, Faciszewski T. Intravertebral clefts in osteoporotic vertebral compression fractures. Arthritis Rheum 2003;48:1414–9.

    Article  PubMed  Google Scholar 

  18. Mathis JM. Vertebroplasty for vertebral fractures with intravertebral clefts. AJNR Am J Neuroradiol 2002;23:1619–20.

    PubMed  PubMed Central  Google Scholar 

  19. Hasegawa K, Homma T, Uchiyama S, Takahashi H. Vertebral pseudarthrosis in the osteoporotic spine. Spine (Phila Pa 1976) 1998;23:2201–6.

    Article  CAS  Google Scholar 

  20. Dupuy DE, Palmer WE, Rosenthal DI. Vertebral fluid collection associated with vertebral collapse. AJR Am J Roentgenol 1996;167:1535–8.

    Article  CAS  PubMed  Google Scholar 

  21. Lee CS, Yu JW, Chung SS, Suh YL, Ahn G, Ahn JM. Delayed Posttraumatic Vertebral Collapse: MR Categorization and MR-Pathology Correlation. Asian Spine J 2007;1:32–7.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Osterhouse MD, Kettner NW. Delayed posttraumatic vertebral collapse with intravertebral vacuum cleft. J Manipulative Physiol Ther 2002;25:270–5.

    Article  PubMed  Google Scholar 

  23. Krauss M, Hirschfelder H, Tomandl B, Lichti G, Bär I. Kyphosis reduction and the rate of cement leaks after vertebroplasty of intravertebral clefts. Eur Radiol 2006;16:1015–21.

    Article  PubMed  Google Scholar 

  24. Wang G, Yang H, Chen K. Osteoporotic vertebral compression fractures with an intravertebral cleft treated by percutaneous balloon kyphoplasty. J Bone Joint Surg Br 2010;92:1553–7.

    Article  CAS  PubMed  Google Scholar 

  25. Laredo JD. Expert’s comment concerning Grand Rounds case entitled “Kümmell’s disease: Delayed posttraumatic osteonecrosis of the vertebral body” (by R. Ma, R. Chow, F. H. Shen). Eur Spine J 2010;19:1071–2.

    Article  PubMed  Google Scholar 

  26. Wagner AL, Baskurt E. Refracture with cement extrusion following percutaneous vertebroplasty of a large interbody cleft. AJNR Am J Neuroradiol 2006;27:230–1.

    CAS  PubMed  PubMed Central  Google Scholar 

  27. Wang HS, Kim HS, Ju CI, Kim SW. Delayed bone cement displacement following balloon kyphoplasty. J Korean Neurosurg Soc 2008;43:212–4.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopedic, Henan Provincial People’s Hospital, Zhengzhou University People’s Hospital, No. 7, Weiwu Road, Zhengzhou, 450003, China

    Guang-Quan Zhang,  Yan-Zheng Gao, Shu-Lian Chen, Shuai Ding, Kun Gao & Hong-Qiang Wang

Authors
  1. Guang-Quan Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yan-Zheng Gao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Shu-Lian Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shuai Ding
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Kun Gao
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hong-Qiang Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Yan-Zheng Gao.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Zhang, GQ., Gao, YZ., Chen, SL. et al. Comparison of percutaneous vertebroplasty and percutaneous kyphoplasty for the management of Kümmell’s disease. IJOO 49, 577–582 (2015). https://doi.org/10.4103/0019-5413.168752

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/0019-5413.168752

Key words

MeSH terms

Search

Navigation