Comparison of sacroplasty with or without balloon assistance for the treatment of sacral insufficiency fractures

Purpose: Sacral insufficiency fractures (SIFs) can cause severe lower back pain and immobility, which have limited therapeutic options. No previous studies have compared clinical outcomes and radiographic findings of sacroplasty with or without balloon assistance for the treatment of SIFs. Methods: Forty-five patients with SIFs were divided into two groups. One group had 18 patients treated using sacroplasty with balloon assistance, and the other had 27 patients treated without balloon assistance. The operation time and cement injection volume were compared between these two groups. Clinical outcomes were evaluated using visual analog scale (VAS), Oswestry Disability Index (ODI), and Odom’s criteria. Cement leakage rate was examined by postoperative radiography and computed tomography. Results: Sacroplasty with balloon assistance was associated with significantly longer operative time ( p = 0.003) and larger cement injection volume ( p = 0.038). Cement leakages were found in 4 of 18 patients (22.2%) with balloon assistance and 15 of 27 patients (55.6%) without balloon assistance, which showed significant difference ( p = 0.027). No significant differences were observed between sacroplasty with and without balloon assistance with regard to clinical outcomes including improvement in VAS, ODI, and Odom’s criteria. Conclusions: Sacroplasty with balloon assistance was shown to achieve greater cement injection with longer operation time and can decrease the risk of cement leakage. Both sacroplasty with and without balloon assistance showed good-to-excellent clinical outcomes for the treatment of SIFs.

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Comparison of a flexible versus rigid bone cement injection system in unilateral percutaneous vertebroplasty.

10.21203/rs.3.rs-16060/v1 ◽

2020 ◽

Author(s):

yuwei li ◽

wei cui ◽

peng zhou ◽

cheng li ◽

yan wen ◽

...

Keyword(s):

Vertebral Fracture ◽

Radiation Exposure ◽

Bone Cement ◽

Vertebral Body ◽

Percutaneous Vertebroplasty ◽

Operation Time ◽

Cement Leakage ◽

X Ray ◽

Cement Injection ◽

Significant Difference

Abstract Background: Percutaneous vertebroplasty (PVP) has been demonstrated to be effective in the treatment of acute osteoporotic vertebral fracture (AOVF). However, bilateral puncture takes more time to accept more X-ray irradiation; some scholars apply unilateral puncture PVP, but the cement cannot be symmetrically distributed in the vertebral body, so we use a flexible cement injector that undergoes PVP through the unilateral pedicle puncture. This research aims to compare the clinical results of PVP for AOVF with unilateral pedicle puncture using a straight bone cement injector and a bendable cement injector, determine the value of a bendable cement injector.Methods: We undertook a retrospective analysis of patients with thoracic and lumbar compression fracture treated with unilateral pedicle puncture Percutaneous vertebroplasty from our institution from June 2013 to July 2015. Operation time, radiation exposure, bone cement injection amount, and the incidence of bone cement leakage were recorded on presentation, the cement leakage was measured by x-ray and computed tomography scan. The patients were followed up postoperatively and were assessed mainly with regard to clinical and radiological outcomes.Results: There was no significant difference in the operation time, radiation exposure time and incidence of bone cement leakage between the two groups. There was significant difference in the amount of bone cement injection and the difference between the two groups. there were no significant differences in VAS and the relative height of the vertebral body and local Cobb angle and QUALEFFO between 2 groups at 1 week after PVP, only significant difference was observed between 12 months after operation.Conclusions: Application of flexible cement injector is safe and feasible,Compared with the application of straight bone cement injector, without prolonging the operative time, radiation exposure time and the incidence of bone cement leakage, it has the advantages of good long-term effect and low incidence of vertebral fracture recurrence.

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Comparison of a flexible versus rigid bone cement injection system in unilateral percutaneous vertebroplasty

10.21203/rs.3.rs-21372/v1 ◽

2020 ◽

Author(s):

yuwei li ◽

wei cui ◽

peng zhou ◽

cheng li ◽

yan wen ◽

...

Keyword(s):

Vertebral Fracture ◽

Radiation Exposure ◽

Bone Cement ◽

Vertebral Body ◽

Percutaneous Vertebroplasty ◽

Operation Time ◽

Cement Leakage ◽

X Ray ◽

Cement Injection ◽

Significant Difference

Abstract Background: Percutaneous vertebroplasty (PVP) has been demonstrated to be effective in the treatment of acute osteoporotic vertebral fracture (AOVF). However, bilateral puncture takes more time to accept more X-ray irradiation; some scholars apply unilateral puncture PVP, but the cement cannot be symmetrically distributed in the vertebral body, so we use a flexible cement injector that undergoes PVP through the unilateral pedicle puncture. This research aims to compare the clinical results of PVP for AOVF with unilateral pedicle puncture using a straight bone cement injector and a bendable cement injector, determine the value of a bendable cement injector. Methods: We undertook a retrospective analysis of patients with thoracic and lumbar compression fracture treated with unilateral pedicle puncture Percutaneous vertebroplasty from our institution from June 2013 to July 2015. Operation time, radiation exposure, bone cement injection amount, and the incidence of bone cement leakage were recorded on presentation, the cement leakage was measured by x-ray and computed tomography scan. The patients were followed up postoperatively and were assessed mainly with regard to clinical and radiological outcomes. Results: There was no significant difference in the operation time, radiation exposure time and incidence of bone cement leakage between the two groups. There was significant difference in the amount of bone cement injection and the difference between the two groups. there were no significant differences in VAS and the relative height of the vertebral body and local Cobb angle and QUALEFFO between 2 groups at 1 week after PVP, only significant difference was observed between 12 months after operation. Conclusions: Application of flexible cement injector is safe and feasible,Compared with the application of straight bone cement injector, without prolonging the operative time, radiation exposure time and the incidence of bone cement leakage, it has the advantages of good long-term effect and low incidence of vertebral fracture recurrence.

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Unilateral curved versus bipedicular vertebroplasty in the treatment of osteoporotic vertebral compression fractures

BMC Surgery ◽

10.1186/s12893-019-0653-y ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Rui Zhong ◽

Jianheng Liu ◽

Runsheng Wang ◽

Yihao Liu ◽

Binbin Chen ◽

...

Keyword(s):

Compression Fracture ◽

Operation Time ◽

Cement Leakage ◽

Leakage Rate ◽

Vertebral Compression Fractures ◽

Osteoporotic Vertebral Compression Fractures ◽

Compression Fractures ◽

Significant Difference ◽

Vas Scores ◽

Postoperative Improvement

Abstract Background Vertebral compression fracture is one of the most common complications of osteoporosis. In this study an unilateral curved vertebroplasty device was developed, and the safety, effectiveness, and surgical parameters of curved vertebroplasty (CVP) in the treatment of painful osteoporotic vertebral compression fractures was investigated and compared with traditional bipedicular vertebroplasty (BVP). Methods We investigated 104 vertebral augmentation procedures performed over 36 months. CVP and BVP procedures were compared for baseline clinical variables, pain relief (Visual Analog Scale, VAS), disability improvement (Oswestry Disability Index, ODI), operation time, number of fluoroscopic images, volume of cement per level, and cement leakage rate for each level treated. Complications and refracture incidence were also recorded in the two groups. Results The VAS and ODI in both group had no significant difference preoperative (P > 0.05), and a significant postoperative improvement in the VAS scores and ODI was found in both group (P < 0.001). However, the CVP group had significantly lower operation time, number of fluoroscopic images, and cement leakage rate per level than the BVP group (P < 0.05); however, the volumes of cement per level were similar in the two groups (P > 0.05). Neither group had any serious complications. Five and two patients in the BVP group developed refractures at non-adjacent and adjacent levels, respectively, with one patient developing refractures twice; however, none of the patients in the CVP group developed refractures at any level. Conclusions Our findings revealed that both CVP and BVP were safe and effective treatments for osteoporotic vertebral compression fractures, and CVP entails a shorter operation time, less exposure to fluoroscopy, and lower rate of cement leakage.

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Balloon-assisted sacroplasty as a successful procedure for osteoporotic sacral insufficiency fractures after failure of the conservative treatment

Scientific Reports ◽

10.1038/s41598-020-75384-z ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

D. Schwetje ◽

Y. El Sayed Hassan Wahd ◽

R. Bornemann ◽

T. R. Jansen ◽

R. Pflugmacher ◽

...

Keyword(s):

Conservative Treatment ◽

Scientific Literature ◽

Surgical Complication ◽

Cement Leakage ◽

Symptomatic Therapy ◽

Insufficiency Fractures ◽

Risk Of Infection ◽

Osteoporotic Vertebral Fractures ◽

Sacral Insufficiency Fractures ◽

A Minor

Abstract Osteoporotic vertebral fractures without prior adequate traumatization are frequent diagnosed in orthopedics because of the increasing life expectancy and incidence of osteoporosis. The associated high mortality is caused by reduced mobilization which leads to a higher risk of infection and a bedridden state. On the other hand the diagnosis of sacral insufficiency fractures is often prolonged because of unspecific symptoms while being associated with similar risks. This article presents an overview of the present scientific literature and a retrospective analysis of patients treated via balloon-assisted sacroplasty. In 8 years, ten patients (three men and seven women) were treated. The average age was 78.4 years and the average time until the diagnosis 4.6 weeks. In most patients a significant pain reduction after the failure of conservative treatment thanks to operative treatment as well as increased mobility was observed. Only one experienced a minor surgical complication being cement leakage with nerval impaction which did not compromise her clinical outcome or satisfaction with the procedure. Balloon-assisted sacroplasty can possibly be seen as an effective symptomatic therapy in osteoporotic insufficiency fractures.

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A Tentative Study of Individual Puncture Path of PVP/ PKP in Treating OVCFs

10.21203/rs.3.rs-666393/v1 ◽

2021 ◽

Author(s):

Sheng Guo ◽

Changming Xiao ◽

Chenglong Wang ◽

Sen Li

Keyword(s):

Operation Time ◽

Clinical Work ◽

The Elderly ◽

Cement Leakage ◽

Vertebral Compression Fractures ◽

Surgical Methods ◽

Significant Difference ◽

Vas Scores ◽

Better Than

Abstract Background: The prior objective of this study is to discuss individualized puncture path of percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) in the treatment of the elderly with severe osteoporotic vertebral compression fractures (OVCFs).Previous studys have compared the clinical efficacy and safety of PVP and PKP. Based on their research results, we will make a further investigation about this two main operations in treating OVCFs and propose a set of original and feasible puncture plan in clinical work, which will improve efficiency and safety of PKP and PVP.Methods: We searched all the articles related to PVP and PKP in treating OVCFs on medicine database. Issues of the selected journals published from 1999 to 2020 were hand-searched by us, including experimental or review articles. Combining conclusions of these researches and clinical cases of our department, we are forged to find more common and preferred treatments for patients with OVCFs under different situations.Results: Most of thees studies revealed that there was no significant difference in relieving the back pain and improving the quality of patients’ life between PVP and PKP surgeries, which generally based on the VAS scores and Oswestry disability index(ODI) scores. However, PKP has a lower rate of bone cement leakage and incidence of adjacent vertebrae fracture than the PVP. Restoring the vertebral height and local kyphotic angle corrections of PKP are much better than that of PVP. On the other hand, more operation time, higher cost and rate of re-surgery of PKP should also be taken into consideration when we make better choice for patients. Therefore, we are forged to find individual methods for patients who are diagnosed as OVCFs.Conclusions: Both the two types of operation can significantly relieve the pain of the patients ,reduce the risk of occurring complication and mortality after OVCFs. There is no so-called best treatment for patients between PVP and PKP. We should take the comprehensive actual conditions into account when choosing surgical methods for patients with OVCFs, which is absolutely vital to us. However, individual puncture path is beneficial for us to make operations including both PKP and PVP.

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Clinical Efficacy of Different Bone Cement Distribution Patterns in Percutaneous Kyphoplasty: A Retrospective Study

January 2018 - Pain Physician ◽

10.36076/ppj.2020/23/e409 ◽

2020 ◽

Vol 4;23 (7;4) ◽

pp. E409-E416

Author(s):

Tianming Zou

Keyword(s):

Bone Cement ◽

Clinical Outcomes ◽

Distribution Patterns ◽

Cement Leakage ◽

Percutaneous Kyphoplasty ◽

Significant Difference ◽

Cement Distribution ◽

Group A ◽

The Mean

Background: Bone cement distribution patterns in percutaneous kyphoplasty (PKP) is the key factor in keeping the vertebral stabilization and curative effect. However, the same cement volume can result in different bone cement distribution patterns and can thereby lead to different clinical outcomes. Therefore we investigated associations between cement distribution patterns and the occurrence rates of recompression in cemented vertebrae after PKP for patients with osteoporotic vertebral compression fractures (OVCFs). Objectives: The study focuses attention on the influence of compact and dispersive cement distribution patterns in PKP for patients with OVCFs. Study Design: A retrospective cohort study. Setting: An affiliated people’s hospital of a university. Methods: According to different cement distribution patterns, patients were assigned to 4 groups. The demographic data, radiographic data, and clinical outcomes were compared between the 4 groups. The Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) were evaluated before and 2 days after PKP. Moreover, the relationships between bone cement and clinical outcomes were analyzed. The epidemiologic data, clinical outcomes, and complications of the 4 groups were assessed. Comparisons of the radiologic and clinical results of the 4 groups were made pre- and postoperatively. Anterior height of fractured vertebrae (AH), the kyphotic Cobb angle, and the volumetric cubage index of the fractured vertebrae were measured. Results: A total of 104 subjects were retrospectively analyzed and followed up (median age, 75.01 ± 8.42 years; age range, 56–94 years). The mean procedure duration was 61.26 ± 23.05 minutes (range, 30–140 minutes). The mean follow-up was 12.1 ± 2.2 months (range, 2–15 months). Statistically, there was no significant difference in terms of gender, age, body mass index, and bone mineral density (P > 0.05). The incidence of cement leakage was significantly lower in group A than those in the other groups. The total amount of bone cement injected into 104 cases (104 vertebral bodies in total) was 848.5 mL, and the amount of bone cement injected into a single vertebral body was 7.94 ± 1.38 mL. The amount of bone cement injection in each group was the lowest (6.80 ± 1.66 mL) in group D, followed by (7.94 ± 1.38 mL) group B, and the highest (8.96 ± 1.68 mL) in group A, with a statistically significant difference between the 4 groups (P < 0.05). No serious complications were observed during the follow-up periods. The AH and Cobb angle improved significantly for the 4 groups (P < 0.05). The VAS score decreased from 3.55 ± 0.54, 3.53 ± 0.65, 3.40 ± 0.58, and 3.40 ± 0.66 preoperatively to 0.18 ± 0.39, 0.23 ± 0.41, 0.20 ± 0.40, and 0.15 ± 0.36 at 48 hours postoperatively. The ODI score dropped from 35.65 ± 4.54, 36.45 ± 4.72, 34.12 ± 4.86, and 35.65 ± 4.34 preoperatively to 15.47 ± 1.32, 15.32 ± 1.34, 15.23 ± 1.26, and 15.73 ± 1.17 at 48 hours postoperatively. Limitations: Our estimation of the vertebral body volume is imprecise. In addition, the number of subjects with OVCFs was small in this retrospective study. The volume of the fractured vertebra was not calculated accurately. Conclusions: Significant associations between cement distribution patterns and bone cement leakage affected the clinical outcome in patients after PKP. A higher incidence of bone cement leakage was observed in patients with treated vertebrae exhibiting a single-dispersive or single-compact pattern. Key words: Percutaneous kyphoplasty, osteoporotic vertebral compression fracture, bone cement distribution patterns

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Comparison of the clinical outcomes of percutaneous vertebroplasty vs. kyphoplasty for the treatment of osteoporotic Kümmell’s disease:a prospective cohort study

10.21203/rs.3.rs-15968/v1 ◽

2020 ◽

Author(s):

Jian-Zhong Chang ◽

Ming-Jian Bei ◽

Dong-Ping Shu ◽

Cheng-Jun Sun ◽

Ji-Bin Chen ◽

...

Keyword(s):

Blood Loss ◽

Bone Cement ◽

Percutaneous Vertebroplasty ◽

Operation Time ◽

Cement Leakage ◽

Significant Difference ◽

Kummell’S Disease ◽

Adjacent Vertebra ◽

Kümmell’S Disease ◽

Time Point

Abstract Background Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are widely used in the treatment of Kümmell's disease. The purpose of this article is to investigate the clinical efficacy of PVP and PKP for Kümmell's disease. Methods The clinical data that 56 cases of OVCF treated with either PVP (28 cases) or PKP (28 cases) and met the selection criteria from December 2015 to December 2017 were prospectively analyzed. Gender, age, course of disease, injury segment, BMD, VAS, ODI, imaging measurement indexes before surgery between the two groups showed no significant difference (all P>0.05). The bone cement leakage rate, bone cement injection amount, operation time, VAS, ODI, the rate of vertebral compression, correction rate of kyphosis and refracture rate of adjacent vertebra in 2 years were compared between the two groups to calculate clinical efficacy. Results The two groups were followed up for 24-48 months. There was no significant difference in the follow-up time, amount of bone cement injected, incidence of bone cement leakage and refracture rate of adjacent vertebra between the two groups (all P > 0.05). The operation time, intraoperative blood loss and fluoroscopy times of the PVP group were significantly lower than those of the PKP group (all P = 0.000). VAS score and ODI of the two groups were significantly lower at 1 d, 1 year and 2 years after surgery than before surgery (all P <0.05), but there was not statistically significant difference between the two groups at each time point after surgery (all P> 0.05). The rate of vertebral compression and kyphosis correction in the two groups were significantly corrected (P <0.05, respectively) and decreased significantly with time (all P <0.05), But there was not significant difference between the two groups at any time point (all P> 0.05). Conclusion Both PVP and PKP can achieve similar effects in the treatment of Kümmell's disease. Because the cost, operation time, blood loss, radiation exposure and surgical procedure of PVP are less than those of PKP, PVP has more clinical priority value.

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Comparison of Pedicle Screw Fixation With or Without Cement Augmentation Combined With Single-segment Isthmic Spondylolisthesis in Osteoporotic Spine

10.21203/rs.3.rs-1051822/v1 ◽

2021 ◽

Author(s):

Jian-cheng Peng ◽

Hui-zhi Guo ◽

Chen-guang Zhan ◽

Hua-sheng Huang ◽

Yan-huai Ma ◽

...

Keyword(s):

Pedicle Screw ◽

Screw Fixation ◽

Operation Time ◽

Cement Leakage ◽

Fusion Rate ◽

Pedicle Screw Fixation ◽

Isthmic Spondylolisthesis ◽

Screw Loosening ◽

Single Segment ◽

Significant Difference

Abstract PurposeThis study aims to investigate the necessity of cement-augmented pedicle screw fixation in single-segment isthmic spondylolisthesis with osteoporosis.MethodFifty-nine cases were reviewed retrospectively. Thirty-three cases were in the polymethylmethacrylate-augmented pedicle screw (PMMA-PS) group, and the other 26 cases were in the conventional pedicle screw (CPS) group. Evaluation data included operation time, intraoperative blood loss,hospitalization cost, hospitalization days, rates of fusion, screw loosening, bone cement leakage, visual analog scores (VAS) , Oswestry disability index (ODI) , Lumbar Lordosis（LL）, Pelvic Tilt（PT） and Sacral Slope（SS）. ResultsThe operation time and blood loss in the CPS group decreased significantly compared to the PMMA-PS group (P < 0.05). The average hospitalization cost of the PMMA group was significantly higher than that of the CPS group (P < 0.05). There was no significant difference for the average hospital stay between the 2 groups (P > 0.05). The initial and the last follow-up postoperative VAS and ODI improved significantly in the two groups (P < 0.05). There were no significant differences in VAS and ODI at each time point between the 2 groups (P > 0.05). The last postoperative spine-pelvic parameters were significantly improved compared with preoperation (P < 0.05). In the PMMA-PS group, the fusion rate was 100%. The fusion rate was 96.15% in the CPS group. No significant difference was found between the two groups for the fusion rate (P > 0.05). Nine cases in the PMMA-PS group had bone cement leakage (27.27%). There was not screw loosening in the PMMA-PS group. There were 2 cases of screw loosening in the CPS group. There were no significant differences in screw loosening, postoperative adjacent segment fractures, postoperative infection or postoperative revision between the 2 groups (P > 0.05). ConclusionsThe use of PMMA-PS on a regular basis is not recommended for posterior lumbar interbody fusion for the treatment of single-segment isthmic spondylolisthesis with osteoporosis.

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Comparison of percutaneous vertebroplasty with a side-hole push rod and conventional percutaneous vertebroplasty for the treatment of OVCFs

10.21203/rs.3.rs-32093/v1 ◽

2020 ◽

Author(s):

Zhengshuai Jin ◽

Hailong Zhou ◽

Xuefei Yan ◽

Chunming Wang ◽

Yuanqing Mao ◽

...

Keyword(s):

Bone Cement ◽

Operative Time ◽

Percutaneous Vertebroplasty ◽

Cement Leakage ◽

Vertebral Compression Fractures ◽

Postoperative Results ◽

Injection Volume ◽

Side Hole ◽

Cement Injection

Abstract ObjectiveThe aim of this study was to compare the clinical efficacy of percutaneous vertebroplasty with a side-hole push rod (modified PVP) and conventional PVP in treating osteoporotic vertebral compression fractures (OVCFs).Materials and methodsThis study included 69 patients with 1-level OVCFs. Perioperative indicators, including the operative time, cement injection volume, cement leakage rate, and distribution of cement in the fractured area, were analysed. The visual analogue scale (VAS) and Oswestry disability index (ODI) were administered pre- and postoperatively.ResultsNo significant differences were observed in the operative time or cement injection volume between the two groups (p > 0.05). The total diffusion score of bone cement in the PVP group was significantly lower than that in the modified PVP group (p < 0.05). Compared with the conventional PVP group, the modified PVP group had a significantly lower VAS score at 3 days postoperatively (p < 0.05). There were no differences in the VAS or ODI scores between the two groups at the last follow-up (p > 0.05). Bone cement leakage was observed in 15 cases in the conventional PVP group (15/32) and in 9 cases in the modified PVP group (9/37).ConclusionThe modified version of PVP provides sufficient cement to fill the fractured area and is associated with a lower incidence of cement leakage and undesired postoperative results than is conventional PVP, indicating that modified PVP is a safe and effective new technique for the treatment of OVCFs.

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Bone-filling mesh container versus percutaneous kyphoplasty in treating Kümmell’s disease

Archives of Osteoporosis ◽

10.1007/s11657-019-0656-4 ◽

2019 ◽

Vol 14 (1) ◽

Author(s):

Z.-K. Duan ◽

J.-F. Zou ◽

X.-L. He ◽

C.-D. Huang ◽

C.-J. He

Keyword(s):

Vertebral Body ◽

Operation Time ◽

Cement Leakage ◽

Percutaneous Kyphoplasty ◽

Relieve Pain ◽

Significant Difference ◽

Kummell’S Disease ◽

Cobb’S Angle ◽

Bone Filling ◽

Kümmell’S Disease

Abstract Summary Kümmell’s disease (eponymous name for osteonecrosis and collapse of a vertebral body due to ischemia and non-union of anterior vertebral body wedge fractures after major trauma) cannot heal spontaneously. Bone-filling mesh container (BFMC) can significantly relieve pain, help the correction of kyphosis, and may prevent cement leakage. This pilot study may provide the basis for the design of future studies. Purpose To compare the effectiveness and safety of BFMC and percutaneous kyphoplasty (PKP) for treatment of Kümmell’s disease. Methods From August 2016 to May 2018, 40 patients with Kümmell’s disease were admitted to Guizhou Provincial People’s Hospital. Among them, 20 patients (20 vertebral bodies) received PKP (PKP group) and the other 20 received BFMC (BFMC group). Operation time, Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), Cobb’s angle changes, and related complications were recorded. Results All patients underwent operations successfully. VAS scores and ODI of both groups at each postoperative time point were lower than preoperatively, with statistically significant difference (p < 0.05). Postoperative Cobb’s angle of both groups postoperatively was lower than preoperatively (p < 0.05). Cement leakage occurred in eight vertebrae (8/20) in the PKP group and in one vertebra (1/20) in the BFMC group. No complications such as pulmonary embolism, paraplegia, or perioperative death occurred during operation in both groups. Adjacent vertebral refractures occurred in five patients (5/20) in the PKP group and in four patients (4/20) in the BFMC group, with no significant difference in the incidence rate of refractures in both groups but the material is too small to verify statistically. Conclusions Both PKP and BFMC technologies can significantly relieve pain and help the correction of kyphosis while treating Kümmell’s disease. Moreover, the BMFC may prevent cement leakage.

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