Percutaneous Vertebroplasty Using A Rotary Cutter For Treating Kiimmell'S Disease With Intravertebral Vacuum Cleft

Background: Reported 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.Objectives: This study was to prospectively investigate the advantage of rotary cutter-PVP (RCPVP) in patients with KOmmell's disease with IVC.Study Design: A prospective outcome study.Setting: A tertiary care hospital.Methods: Patients 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.Results: This 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.Limitations: The small number of included patients and no long-term follow-up.Conclusions: RC-PVP, with the destruction of IVC, may lead to better clinical outcomes with fewer complications.