A Comparison of Hyperextension versus Neutral Positions for Vertebroplasty to Treat Neurologically Intact Kümmell Disease

Abstract

Objective: To compare the efficacy between hyperextension position (HPVP) and neutral position for vertebroplasty (NPVP) in treating Kümmell disease. Study Design: A Comparative descriptive study. Place and Duration of Study: Department of Orthopaedics, Yantaishan Hospital, China, from December 2017 to July 2018. Methodology: This study retrospectively analysed demographic features, operative information, radiologic data, and complications of 58 consecutive patients with single-level Kummel disease (KD) who underwent NPVP (n=27) or HPVP (n=31). All patients were observed preoperatively and at 2 days (POD 2) and one year postoperatively for cement leakage, Cobb’s angle, antenior body height ratio, pain and disability. Results: The cement leakage rate was significantly lower in the HPVP group (p<0.01). The visual analogue scale (VAS) scores for pain, and Oswestry disability indices (ODIs) were lower in the HPVP group at one year postoperatively (both p<0.05). For the HPVP group, Cobb’s angle was significantly smaller, and the anterior body height ratio (AR) was larger at POD 2 (p<0.05) and one year (p<0.05), postoperatively. Conclusion: This study demonstrated that HPVP could achieve a lower cement leakage rate with similar operative time, lower VAS and ODI scores, as well as better kyphosis restoration and AR recovery at the 1-year follow-up than NPVP. HPVP is thus superior to NPVP in treating KD.