Clinical effects of posterior approach vertebral column resection osteotomy combined with titanium mesh bone-graft fusion and internal fixation in the treatment of special type stage IIIb Kummell disease
10.3760/cma.j.cn121113-20250102-00005
- VernacularTitle:后路全脊椎切除矫形融合内固定术治疗上、下终板均破裂的Ⅲb期Kümmell病
- Author:
Yunlong JIAO
1
;
Ying GUO
1
;
Meng ZHANG
1
;
Xiaowei GUO
1
;
Yulin PAN
1
;
Huaishuan ZHANG
1
;
Wei SHEN
1
;
Wei MEI
1
Author Information
1. 郑州市骨科医院脊柱二科，郑州 450052
- Publication Type:Journal Article
- Keywords:
Thoracic vertebrae;
Lumbar vertebrae;
Osteonecrosis;
Osteotomy;
Spinal fusion
- From:
Chinese Journal of Orthopaedics
2025;45(9):588-595
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the clinical outcomes of posterior approach vertebral column resection (VCR) osteotomy combined with titanium mesh bone-graft fusion and internal fixation for the treatment of special type stage IIIb Kummell disease.Methods:Twelve patients (3 males, 9 females) diagnosed with special type stage IIIb Kummell disease at Zhengzhou Orthopedics Hospital between October 2015 and June 2021 were enrolled. The mean age was 59.1±5.6 years (range, 53-67 years). All patients underwent VCR osteotomy, pedicle screw fixation, and posterior bone-graft fusion using titanium mesh. Preoperative and postoperative outcomes were assessed using visual analogue scale (VAS) scores, Oswestry Disability Index (ODI), Japanese Orthopaedic Association (JOA) scores, American Spinal Injury Association (ASIA) grading, Cobb angle correction, and bone graft fusion rate. Intraoperative and postoperative complications were also recorded.Results:All surgeries were completed successfully. The average follow-up duration was 11.6±1.8 months (range, 10-13 months). Significant improvements were observed in VAS scores, ODI, JOA scores, and Cobb angles at both two weeks postoperatively and at the final follow-up ( P<0.05), with no significant differences between the two time points ( P>0.05). The final recovery rates were 79.5% for VAS score, 73.2% for ODI, 72.1% for JOA score, and 77.3% for Cobb angle correction. Neurological function showed marked improvement. One patient developed delayed incision healing due to fat liquefaction but recovered following physical therapy. The remaining 11 patients experienced uneventful wound healing without infection or internal fixation loosening. One patient developed postoperative deep venous thrombosis of the lower limbs, which resolved with drug therapy. Conclusion:Posterior approach VCR combined with titanium mesh bone-graft fusion and internal fixation provides an effective surgical option for stage IIIb Kummell disease characterized by fractured vertebral bodies with only the broken upper and lower endplates remaining.
