• Chen Zhong, Gang Min, Xun-Wei Liu, Zhen Yang, Shuai Li, and Min Li.
• Department of Oncology, PLA 960th Hospital, Jinan, Shandong, P.R. China.
• Pain Physician. 2021 Jul 1; 24 (4): E477-E482.

BackgroundReported data indicate that the curative effect of percutaneous vertebroplasty (PVP) on the patients with intravertebral vacuum cleft (IVC) is worse than on those without IVC.ObjectivesThis study was to prospectively investigate the advantage of rotary cutter-PVP (RC-PVP) in patients with Kümmell's disease with IVC.Study DesignA prospective outcome study.SettingA tertiary care hospital.MethodsPatients who underwent conventional PVP served as the control group. For the RC-PVP group, the rotary cutters were applied before the cement injection to destroy the IVC structure and the surrounding necrotic bone. The following data were compared between the two groups: the cement filling patterns, effective therapeutic rate, the pre- to post-procedural changes of spinal geometry, and the subsequent fractures.ResultsThis study included a total of 64 patients (30 and 34 patients in RC-PVP group and control group, respectively). In the RC-PVP group, the cement in 26 cases was filled as a mixed pattern, while the filling pattern in the control group was mainly the cystic type (n = 31). There were no significant differences in the height restoration rate between the RC-PVP and control groups (32.7 ± 13.6 and 32.4 ± 13.9, respectively, P = 0.93). The RC-PVP group had a higher effective rate during the first week and the first month (93.3% vs. 70.6%, P = 0.02) and at 3 months (90.4% vs. 73.9%, P = 0.03). Long-term follow-up indicated that vertebral recollapse of the same treated vertebral body occurred in 5 patients after conventional PVP, which was not observed in the RC-PVP group.LimitationsThe small number of included patients and no long-term follow-up.ConclusionsRC-PVP, with the destruction of IVC, may lead to better clinical outcomes with fewer complications.

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