Clinical Efficacy of Percutaneous Kyphoplasty at the Hyperextension Position for the Treatment of Osteoporotic Kummell Disease

Background Data: Percutaneous kyphoplasty might be effective for osteoporotic Kummell disease. Objective: To investigate the clinical efficacy of percutaneous kyphoplasty in hyperextension for osteoporotic Kummell disease. Study Design: Retrospective study. Methods: A retrospective analysis was carried out on data from downstream balloon kyphoplasty treatments in hyperextension for 18 patients with osteoporotic Kummell disease. All cases were single-segment disease affecting T5 (1 case), T7 (1 case), T8 (2 cases), T11 (6 cases), T12 (4 cases), L1 (2 cases), L2 (1 case), or L4 (1 case). Dual-energy x-ray absorptiometry bone mineral density values ranged from -2.8 to -5.8 SD. The sagittal Cobb angle of the involved segment was measured before and after the operation and the final follow-up also included a visual analog pain score (VAS) and the Oswestry Disability Index (ODI) after comprehensive efficacy assessment. Results: All patients were followed up for 12-36 months, with an average of 15.8 months. Patients showed lower back pain relief and improvement in daily life activities. The kyphosis Cobb angle improved from 32.60 +/- 3.82 degrees before surgery to 7.60 +/- 1.68 degrees after surgery, and VAS and ODI scores significantly improved from 8.7 +/- 0.96 points and 88.6 +/- 3.76% to 2.6 +/- 0.32 points and 28.6 +/- 2.67%, respectively. The last follow-up for the kyphosis Cobb angle yielded a value of 9.60 +/- 2.06 degrees, and VAS and ODI averaged 2.2 +/- 0.26 points and 26.4 +/- 2.46%, respectively. Compared with 2 days postoperatively, the differences were not statistically significant. Intervertebral cement leakage occurred in 1 case, but no symptom was observed and no treatment was performed. Conclusion: Percutaneous balloon kyphoplasty in the hyperextension position is an effective method for osteoporosis in Kummell disease.