Effect of the short segment nail rod fxation combined with injured vertebral bone grafting in the treatment of unstable Kümmell disease

ObjectiveTo explore the clinical effect of short segment nail rod fixation combined with injured vertebral bone grafting in the treatment of unstable Kümmell disease.

MethodsThe clinical data of 47 patients with unstable Kümmell disease were retrospectively analyzed.Twenty-five patients treated with short segmental nail rod fixation combined with injured vertebral bone grafting were set as the injured vertebral bone grafting group, and 22 patients treated with short segment nail rod fixation combined vertebroplasty were set as the vertebroplasty group.The surgery-related indicators between two groups were compared.The pain visual analogue(VAS)score, Cobb angle and anterior margin height ratio of injured vertebrae before surgery, after 7 days, 6 months and last following-up of operation were compared between two groups.The occurrence of complications in two groups was recorded.

ResultsThe differences of the operation time, amount of bleeding and length of hospital stay between two groups were not statistically significant(P>0.05).After 7 days, 6 months and last following-up of operation, the height ratio of anterior margin in two groups were significantly higher than that before operation(P < 0.01), the VAS score and Cobb angle were significantly lower than that before surgery(P < 0.01).The 7-day VAS score in injured vertebraling bone grafting group was significantly higher than that in vertebroplasty group(P < 0.01), and the VAS scores in injured vertebral bone grafting group after 6 months and last following-up of operation were significantly lower than that in vertebroplasty group(P < 0.01).The differences of the Cobb angle and height ratio of anterior margin between two groups were not statistically significant(P>0.05).The incidence rate of complication in vertebroplasty group(31.82%)was significantly higher than that in injured vertebral bone grafting group(8.00%)(P < 0.01).

ConclusionsShort segment nail rod fixation combined with injured vertebral bone grafting and vertebroplasty can effectively restore the vertebral height and physiological curvature of unstable Kümmell disease, which combined with injured vertebral bone grafting can improve the long-term pain, and decrease the incidence rate of complication.