Comparison of the Percutaneous Kyphoplasty “Trinity” Anchoring Technique versus Conventional Percutaneous Kyphoplasty for Kummell Disease: A Retrospective Observational Study

OBJECTIVE: To compare the clinical efficacy and radiological outcomes of the novel percutaneous kyphoplasty (PKP) "Trinity" anchoring technique versus conventional PKP for Kummell disease. METHODS: We retrospectively analyzed 92 patients (January 2019-January 2024) assigned to the PKP "Trinity" (n = 45) or conventional PKP (n = 47) groups. The "Trinity" technique used a bilateral, O-arm-guided approach to construct a continuous cement anchoring complex across the vertebral body, pedicle, and articular process. Perioperative metrics, clinical outcomes, and complications were compared. RESULTS: Baseline characteristics, operative time, and leakage rates were similar between groups (P > 0.05). The Trinity group required significantly higher cement volume (P < 0.05). While immediate postoperative improvements in visual analog scale, Oswestry Disability Index, and radiographic parameters were comparable (P > 0.05), the Trinity group demonstrated superior outcomes regarding pain relief, functional recovery, and vertebral height maintenance at 3 months and final follow-up (P < 0.05). Crucially, the incidence of cement loosening was significantly lower in the Trinity group compared to conventional PKP (2.2% vs. 17.0%, P < 0.05). CONCLUSIONS: While immediate relief is comparable, the PKP "Trinity" technique demonstrates superior mid-term to long-term clinical and radiographic stability. By establishing a robust three-column integrated anchoring complex, this technique significantly mitigates the risk of cement loosening, presenting a safer and more effective alternative for stage I and II Kummell disease.