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Therapeutic Efficacy of Transpedicular Impaction Bone Grafting with Long Segmental Posterior Instrumentation in Stage III Kümmell Disease
- Source :
- Spine.
- Publication Year :
- 2021
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2021.
-
Abstract
- Study design A retrospective review of clinical and radiological parameters. Objective To evaluate the therapeutic efficacy of transpedicular impaction bone grafting (TIBG) with long segmental posterior instrumentation for the treatment of stage III Kummell disease. Summary of background data The optimal treatment for stage III Kummell disease remains controversial and unclear. Theoretically, transpedicular bone grafting can reconstruct anterior column support and reduce the failure of internal fixation, which is an intuitive method for the treatment of Kummell disease. However, the use of this technique has rarely been reported for the treatment of this disease. This study reported the clinical and radiological results of TIBG with long segmental posterior instrumentation for the treatment of stage III Kummell disease. Methods Between August 2011 and December 2017, we retrospectively analyzed 24 patients with stage III Kummell disease who underwent TIBG with long segmental posterior instrumentation. Anterior vertebral heights, kyphotic Cobb angle, visual analog scale (VAS), Oswestry disability index (ODI), and American Spinal Injury Association (ASIA) impairment scale were used to evaluate the effects of surgery. Results The mean time to follow-up was 38.1 ± 10.2 months. The average operative duration was 136 ± 16.5 minutes, and the average intraoperative blood loss was 293 ± 41.3 mL. The VAS, ODI, anterior vertebral heights, and kyphotic Cobb angles were improved significantly at 1 week after surgery compared the preoperative examinations, and were well maintained at the final follow-up evaluation. Fourteen patients (58%) had mild neurological impairments before surgery, with neurological function returning to normal at the final follow-up evaluation. There was no instance of instrumentation failure. Conclusion TIBG combined with long segmental posterior instrumentation is a safe and effective surgical option for stage III Kummell disease.Level of Evidence: 4.
- Subjects :
- medicine.medical_specialty
Visual analogue scale
medicine.medical_treatment
Bone grafting
03 medical and health sciences
0302 clinical medicine
medicine
Humans
Internal fixation
Orthopedics and Sports Medicine
Stage (cooking)
Retrospective Studies
030222 orthopedics
Bone Transplantation
Cobb angle
Impaction
business.industry
Osteonecrosis
Surgery
Oswestry Disability Index
Treatment Outcome
Radiological weapon
Spinal Diseases
Neurology (clinical)
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 03622436
- Database :
- OpenAIRE
- Journal :
- Spine
- Accession number :
- edsair.doi.dedup.....67a25a13860d57f31607bdc054ae907c