• Yuzhi Ning, Ziyu Li, Jiahu Huang, Shuang Xu, Qing Wang, Jiyuan Yan, and Song Wang.
• Department of Orthopaedics, The Affiliated Hospital of Southwest Medical University, Sichuan Province, China.
• Pain Physician. 2024 Mar 1; 27 (3): E327E336E327-E336.

BackgroundKummell's disease (KD) and osteoporotic vertebral compression fracture (OVCF) are commonly found in patients with osteoporosis. Several studies have been conducted on bone cement distribution in OVCF or KD; a comparison between the 2 diseases is rarely reported.ObjectivesTo compare the clinical efficacy and bone cement distribution difference between KD and OVCFs after percutaneous kyphoplasty (PKP).Study DesignThis was a retrospective, nonrandomized controlled study.SettingDepartment of Orthopedics from an affiliated hospital.MethodsFrom January 2018 to December 2020, 61 patients who underwent PKP surgery for single KD or OVCF and met the inclusion criteria were retrospectively reviewed. All patients were assigned to 2 groups: the KD group and the OVCF group. Clinical and radiologic characteristics, including the bone cement volume, leakage, bone cement dispersion scale, anterior vertebral height (AVH), median vertebral height (MVH), posterior vertebral height (PVH), Cobb angle and Visual Analog Scale (VAS) were analyzed and compared using Mimics three-dimensional (3D) reconstruction images and 3D reconstruction computed tomography, preoperatively, postoperatively, and 2 years after the operation, respectively. The correlations between the bone cement dispersion scale and the VH improvement rate (VHIR), VH change rate (VHCR), VAS improvement rate (VASIR), and follow-up VAS improvement rate (f-VASIR) were also evaluated.ResultsThe mean follow-up time was 24.0 months. Postoperative VH, Cobb angle, vertebra volume, and VAS score were significantly improved in the 2 groups (P < 0.05). There was no statistical difference in postoperative parameters between the 2 groups. While a strong positive correlation between VHIR and bone cement dispersion scale was observed in the OVCF group (P < 0.01), no significant correlation between VHIR and bone cement dispersion scale was found in the KD group. There was no correlation between VASIR and bone cement dispersion scale in both groups. Compared with postoperation, VH was lower in both groups in later follow-up, and the difference between the 2 groups was statistically significant (P < 0.05). VH, VAS, f-VASIR, and VHCR had a worse manifestation in the KD group than in the OVCF group. However, no significant correlation was found between VHCR, f-VASIR, and bone cement dispersion scale in the 2 groups.LimitationsThis study was limited by the non-randomized design, small sample size, and lack of a comprehensive follow-up period.ConclusionsAlthough there was no significant difference in the bone cement distribution and early clinical efficacy between KD and OVCF patients under the same surgical plan and surgeon, OVCF patients exhibited better long-term radiologic and clinical outcomes.

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