Corpectomy and circumferential fusion for advanced thoracolumbar Kümmell’s disease

被引:23
作者
Cho Y. [1 ]
机构
[1] Department of Neurosurgery, Mok-Dong Hospital, Ewha Womans University College of Medicine, Mok-Dong, YangChun-Gu, Seoul
关键词
Kümmell disease; Neurological deficits; Vertebrectomy;
D O I
10.1007/s12306-017-0480-1
中图分类号
学科分类号
摘要
Background: The aim of this study was to investigate the surgical treatment of neurologically compromised advanced Kümmell’s disease. The surgical treatment of Kümmell’s disease has various options according to clinical and radiologic status. Far collapsed Kümmell’s disease patients with neurological deficit need to be treated surgically. Materials and methods: We retrospectively analyzed 22 patients operated to our hospital with neurologically compromised Kümmell’s disease between January 2011 and January 2014. Surgical approach was vertebrectomy, mesh cage insertion and segmental cement-augmented pedicle screw fixation. Corpectomy tissue was examined histopathologically. Anterior vertebral heights, kyphotic angle, the visual analog scale (VAS) and the Frankel classification were used to evaluate the effects of the surgery. Results: The mean time of follow-up was 26 months (range, 13–40 months). The VAS, anterior vertebral heights, kyphotic angle and neurological state were improved significantly immediate postoperatively and at the last follow-up compared with the preoperative examinations (P < 0.05). Most of the patients in this study exhibited intravertebral clefts, and postoperative pathology revealed bone necrosis. Conclusion: Posterior vertebrectomy with mesh cage insertion and segmental cement-augmented pedicle screw fixation is an effective option for advanced Kümmell’s disease with neurological deficits. © 2017, Istituto Ortopedico Rizzoli.
引用
收藏
页码:269 / 274
页数:5
相关论文
共 18 条
[1]  
Nickell L.T., Schucany W.G., Opatowsky M.J., Kummell disease, Proc (Bayl Univ Med Cent), 26, 3, pp. 300-301, (2013)
[2]  
Linn J., Birkenmaier C., Hoffmann R.T., Reiser M., Baur-Melnyk A., The intravertebral cleft in acute osteoporotic fractures: fluid in magnetic resonance imaging-vacuum in computed tomography?, Spine (Phila Pa 1976), 34, 2, pp. E88-E93, (2009)
[3]  
Oka M., Matsusako M., Kobayashi N., Uemura A., Numaguchi Y., Intravertebral cleft sign on fat-suppressed contrast-enhanced MR: correlation with cement distribution pattern on percutaneous vertebroplasty, Acad Radiol, 12, 8, pp. 992-999, (2005)
[4]  
Wu A.M., Ni W.F., Weng W., Chi Y.L., Xu H.Z., Wang X.Y., Outcomes of percutaneous kyphoplasty in patients with intravertebral vacuum cleft, Acta Orthop Belg, 78, 6, pp. 790-795, (2012)
[5]  
Wu A.M., Chi Y.L., Ni W.F., Vertebral compression fracture with intravertebral vacuum cleft sign: pathogenesis, image, and surgical intervention, Asian Spine J, 7, 2, pp. 148-155, (2013)
[6]  
Osterhouse M.D., Kettner N.W., Delayed posttraumatic vertebral collapse with intravertebral vacuum cleft, J Manipulative Physiol Ther, 25, 4, pp. 270-275, (2002)
[7]  
Zhang X., Hu W., Yu J., Wang Z., Wang Y., An effective treatment option for Kummell disease with neurological deficits: modified transpedicular subtraction and disc osteotomy combined with long-segment fixation, Spine (Phila Pa 1976), 41, 15, pp. E923-E930, (2016)
[8]  
Nakamae T., Fujimoto Y., Yamada K., Hashimoto T., Olmarker K., Efficacy of percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures with intravertebral cleft, Open Orthop J, 9, pp. 107-113, (2015)
[9]  
Capaul M., Zollinger H., Satz N., Dietz V., Lehmann D., Schurch B., Analyses of 94 consecutive spinal cord injury patients using ASIA definition and modified Frankel score classification, Paraplegia, 32, 9, pp. 583-587, (1994)
[10]  
Maldague B.E., Noel H.M., Malghem J.J., The intravertebral vacuum cleft: a sign of ischemic vertebral collapse, Radiology, 129, 1, pp. 23-29, (1978)