Department of Orthopaedic Surgery, Third Affiliated Hospital of Wenzhou Medical University, 108 WanSong Road, Ruian, Wenzhou, Zhejiang, China.
J Orthop Surg Res. 2023 Mar 30;18(1):260. doi: 10.1186/s13018-023-03753-1.
Both percutaneous kyphoplasty (PKP) and percutaneous mesh-container-plasty (PMCP) were important procedures for the treatment of Kümmell's disease. This study aimed to compare the clinical and radiological results of PKP and PMCP for the treatment of Kümmell's disease.
This study included patients with Kümmell's disease treated at our center between January 2016 and December 2019. A total of 256 patients were divided into two groups according to the surgical treatment they received. Clinical, radiological, epidemiological, and surgical data were compared between the two groups. Cement leakage, height restoration, deformity correction, and distribution were evaluated. The visual analog scale (VAS), Oswestry Disability Index (ODI), and short-form 36 health survey domains "role-physical" (SF-36 rp) and "bodily pain" (SF-36 bp) were calculated preoperatively, immediately after surgery, and 1-year postoperatively.
The VAS and ODI scores improved in the PKP [preoperative: 6 (6-7), 68.75 ± 6.64; postoperative: 2 (2-3), 23.25 ± 3.50, respectively] (p < 0.05) and the PMCP [preoperative: 6 (5-7), 67.70 ± 6.50; postoperative: 2 (2-2), 22.24 ± 3.55, respectively] groups (p < 0.05). There were significant differences between the two groups. The mean cost in the PKP group was lower than that in the PMCP group (3697 ± 461 vs. 5255 ± 262 USD, p < 0.05). The cement distribution in the PMCP group was significantly higher than that in the PKP group (41.81 ± 8.82% vs. 33.65 ± 9.24%, p < 0.001). Cement leakage was lower in the PMCP group (23/134) than in the PKP group (35/122) (p < 0.05). The anterior vertebral body height ratio (AVBHr) and Cobb's angle improved in the PKP (preoperative: 70.85 ± 16.62% and 17.29 ± 9.78°; postoperative: 80.28 ± 13.02% and 13.05 ± 8.40°, respectively) and PMCP (preoperative: 70.96 ± 18.01% and 17.01 ± 10.53°; postoperative: 84.81 ± 12.96% and 10.76 ± 9.23°, respectively) groups (p < 0.05). There were significant differences in vertebral body height recovery and segmental kyphosis improvement between the two groups.
PMCP had advantages over PKP in terms of pain relief and functional recovery for the treatment of Kümmell's disease. Moreover, PMCP is more effective than PKP in preventing cement leakage, increasing cement distribution, and improving vertebral height and segmental kyphosis, despite its higher cost.
经皮椎体后凸成形术（PKP）和经皮网袋成形术（PMCP）都是治疗科雷氏病的重要方法。本研究旨在比较 PKP 和 PMCP 治疗科雷氏病的临床和影像学结果。
本研究纳入了 2016 年 1 月至 2019 年 12 月期间在我们中心治疗的科雷氏病患者。根据所接受的手术治疗，将 256 例患者分为两组。比较两组之间的临床、放射学、流行病学和手术数据。评估水泥渗漏、高度恢复、畸形矫正和分布情况。使用视觉模拟量表（VAS）、Oswestry 功能障碍指数（ODI）以及健康调查简表 36 项“角色-生理”（SF-36 rp）和“躯体疼痛”（SF-36 bp）评分分别于术前、术后即刻和术后 1 年进行评估。
PKP [术前：6（6-7），68.75±6.64；术后：2（2-3），23.25±3.50]和 PMCP [术前：6（5-7），67.70±6.50；术后：2（2-2），22.24±3.55]组的 VAS 和 ODI 评分均有改善（p<0.05）。PKP 组的平均费用低于 PMCP 组（3697±461 美元对 5255±262 美元，p<0.05）。PMCP 组的水泥分布明显高于 PKP 组（41.81±8.82%对 33.65±9.24%，p<0.001）。PMCP 组（23/134）的水泥渗漏率低于 PKP 组（35/122）（p<0.05）。PKP 组（术前：70.85±16.62%和 17.29±9.78°；术后：80.28±13.02%和 13.05±8.40°）和 PMCP 组（术前：70.96±18.01%和 17.01±10.53°；术后：84.81±12.96%和 10.76±9.23°）的前椎体高度比（AVBHr）和 Cobb 角均有改善（p<0.05）。两组间椎体高度恢复和节段后凸畸形改善差异有统计学意义。
与 PKP 相比，PMCP 在治疗科雷氏病方面具有缓解疼痛和改善功能恢复的优势。此外，尽管费用较高，但 PMCP 在预防水泥渗漏、增加水泥分布以及改善椎体高度和节段后凸畸形方面比 PKP 更有效。
