A Comparative Study of Two Techniques to Avoid Bone Cement Loosening and Displacement after PVP Treating Unstable Kummell's Disease

Abstract Percutaneous vertebroplasty (PVP) is the most common surgical procedure for Kummell's disease (KD), but bone cement loosening or displacement often occurs after the operation. From May 2015 to May 2019, 77 patients who had received PVP-PPP therapy were included in PPP group, and 42 patients who had received PVP-bone cement bridging screw system therapy were included in screw group. The changes in the vertebral body index (VBI), Cobb angle, visual analog scale (VAS) and Oswestry disability index (ODI) and the bone cement loosening and displacement rate at different follow-up time points were used to evaluate the clinical efficacy. Before operation, immediately after operation and at Month 6 after operation, there was no significant difference in VBI or Cobb angle between two groups (P > 0.05), while at Year-1 and Year-2 postoperative evaluations, screw group had higher VBI and Cobb angle than PPP group (P < 0.05). Before operation, immediately after operation, at Month 6 after operation and at Year-1 after operation, there was no significant difference in VAS or ODI score between two groups (P > 0.05), while at Year-2 after operation, screw group had higher VAS and ODI scores than the PPP group (P < 0.05). The rate of bone cement loosening was 14.29% in group PPP, and 0 in screw group (P < 0.05). This two-year follow-up study shows that PVP-bone cement bridging screw system therapy had better treatment efficacy than PVP-PPP therapy, and the bone cement bridging screw system is a preferred therapy with better anti cement loosening ability.