Clinical efficacy and biomechanical analysis of a novel hollow pedicle screw combined with kyphoplasty for the treatment of Kümmell disease
Abstract Background Vertebral augmentation is the preferred treatment for Kümmell disease (KD), but there exists a risk of cement displacement resulting in severe back pain and exacerbation of kyphosis. The study aimed to investigate the efficacy and safety of a novel hollow pedicle screw combined w...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-12-01
|
| Series: | JOR Spine |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/jsp2.70017 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846107482858979328 |
|---|---|
| author | Shixiao Zhong Hui Zhong Kun Huang Yayu Zhao Wen Lei Weichao Li |
| author_facet | Shixiao Zhong Hui Zhong Kun Huang Yayu Zhao Wen Lei Weichao Li |
| author_sort | Shixiao Zhong |
| collection | DOAJ |
| description | Abstract Background Vertebral augmentation is the preferred treatment for Kümmell disease (KD), but there exists a risk of cement displacement resulting in severe back pain and exacerbation of kyphosis. The study aimed to investigate the efficacy and safety of a novel hollow pedicle screw combined with kyphoplasty (HPS‐KP) for treating KD, effectively preventing postoperative bone cement displacement. Methods The prospective study included 50 KD patients with no neurological deficit detected during clinical and radiological evaluation who underwent HPS‐KP (n = 25) and PKP (n = 25) surgeries. The visual analogue scale (VAS) score, Oswestry dysfunction index (ODI), anterior vertebral height (AVH), wedge‐shape affected vertebral Cobb angle (WCA), bisegmental Cobb angle (BCA), and complications were evaluated and compared in both groups. Besides, a finite element (FE) model of T11‐L2 was constructed. The stress distributions, maximum von Mises stresses of vertebrae and bone cement, and maximum displacement of bone cement were compared and analyzed. Results The VAS and ODI scores at 3 days, 3 and 6 months, and 1 year after surgery significantly improved in both groups (p < 0.05). The AVH, BCA, and WCA significantly improved initially after the surgery in both groups (p < 0.05). The displacement of M2 was larger than other models, especially in flexion, right bending, and left and right rotation, while that of M6 was the lowest under all conditions. Conclusion HPS‐KP was a safe and effective treatment for KD, effectively relieving pain, restoring vertebral height, and correcting local kyphosis, and it had better biomechanical stability and safety than ordinary single PKP and PKP combined with pediculoplasty in avoiding cement loosening and displacement. |
| format | Article |
| id | doaj-art-4c29b22cb2374260ab19d9decaeea0d0 |
| institution | Kabale University |
| issn | 2572-1143 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wiley |
| record_format | Article |
| series | JOR Spine |
| spelling | doaj-art-4c29b22cb2374260ab19d9decaeea0d02024-12-26T11:06:34ZengWileyJOR Spine2572-11432024-12-0174n/an/a10.1002/jsp2.70017Clinical efficacy and biomechanical analysis of a novel hollow pedicle screw combined with kyphoplasty for the treatment of Kümmell diseaseShixiao Zhong0Hui Zhong1Kun Huang2Yayu Zhao3Wen Lei4Weichao Li5Faculty of Medical Science Kunming University of Science and Technology Kunming ChinaDepartment of Orthopaedics, The First People's Hospital of Yunnan Province Affiliated Hospital of Kunming University of Science and Technology Kunming ChinaDepartment of Orthopaedics, The First People's Hospital of Yunnan Province Affiliated Hospital of Kunming University of Science and Technology Kunming ChinaFaculty of Medical Science Kunming University of Science and Technology Kunming ChinaFaculty of Medical Science Kunming University of Science and Technology Kunming ChinaFaculty of Medical Science Kunming University of Science and Technology Kunming ChinaAbstract Background Vertebral augmentation is the preferred treatment for Kümmell disease (KD), but there exists a risk of cement displacement resulting in severe back pain and exacerbation of kyphosis. The study aimed to investigate the efficacy and safety of a novel hollow pedicle screw combined with kyphoplasty (HPS‐KP) for treating KD, effectively preventing postoperative bone cement displacement. Methods The prospective study included 50 KD patients with no neurological deficit detected during clinical and radiological evaluation who underwent HPS‐KP (n = 25) and PKP (n = 25) surgeries. The visual analogue scale (VAS) score, Oswestry dysfunction index (ODI), anterior vertebral height (AVH), wedge‐shape affected vertebral Cobb angle (WCA), bisegmental Cobb angle (BCA), and complications were evaluated and compared in both groups. Besides, a finite element (FE) model of T11‐L2 was constructed. The stress distributions, maximum von Mises stresses of vertebrae and bone cement, and maximum displacement of bone cement were compared and analyzed. Results The VAS and ODI scores at 3 days, 3 and 6 months, and 1 year after surgery significantly improved in both groups (p < 0.05). The AVH, BCA, and WCA significantly improved initially after the surgery in both groups (p < 0.05). The displacement of M2 was larger than other models, especially in flexion, right bending, and left and right rotation, while that of M6 was the lowest under all conditions. Conclusion HPS‐KP was a safe and effective treatment for KD, effectively relieving pain, restoring vertebral height, and correcting local kyphosis, and it had better biomechanical stability and safety than ordinary single PKP and PKP combined with pediculoplasty in avoiding cement loosening and displacement.https://doi.org/10.1002/jsp2.70017Kümmell diseasehollow pedicle screwbone cement displacementfinite element analysisbiomechanical |
| spellingShingle | Shixiao Zhong Hui Zhong Kun Huang Yayu Zhao Wen Lei Weichao Li Clinical efficacy and biomechanical analysis of a novel hollow pedicle screw combined with kyphoplasty for the treatment of Kümmell disease JOR Spine Kümmell disease hollow pedicle screw bone cement displacement finite element analysis biomechanical |
| title | Clinical efficacy and biomechanical analysis of a novel hollow pedicle screw combined with kyphoplasty for the treatment of Kümmell disease |
| title_full | Clinical efficacy and biomechanical analysis of a novel hollow pedicle screw combined with kyphoplasty for the treatment of Kümmell disease |
| title_fullStr | Clinical efficacy and biomechanical analysis of a novel hollow pedicle screw combined with kyphoplasty for the treatment of Kümmell disease |
| title_full_unstemmed | Clinical efficacy and biomechanical analysis of a novel hollow pedicle screw combined with kyphoplasty for the treatment of Kümmell disease |
| title_short | Clinical efficacy and biomechanical analysis of a novel hollow pedicle screw combined with kyphoplasty for the treatment of Kümmell disease |
| title_sort | clinical efficacy and biomechanical analysis of a novel hollow pedicle screw combined with kyphoplasty for the treatment of kummell disease |
| topic | Kümmell disease hollow pedicle screw bone cement displacement finite element analysis biomechanical |
| url | https://doi.org/10.1002/jsp2.70017 |
| work_keys_str_mv | AT shixiaozhong clinicalefficacyandbiomechanicalanalysisofanovelhollowpediclescrewcombinedwithkyphoplastyforthetreatmentofkummelldisease AT huizhong clinicalefficacyandbiomechanicalanalysisofanovelhollowpediclescrewcombinedwithkyphoplastyforthetreatmentofkummelldisease AT kunhuang clinicalefficacyandbiomechanicalanalysisofanovelhollowpediclescrewcombinedwithkyphoplastyforthetreatmentofkummelldisease AT yayuzhao clinicalefficacyandbiomechanicalanalysisofanovelhollowpediclescrewcombinedwithkyphoplastyforthetreatmentofkummelldisease AT wenlei clinicalefficacyandbiomechanicalanalysisofanovelhollowpediclescrewcombinedwithkyphoplastyforthetreatmentofkummelldisease AT weichaoli clinicalefficacyandbiomechanicalanalysisofanovelhollowpediclescrewcombinedwithkyphoplastyforthetreatmentofkummelldisease |