[Clinical observation of gelfoam in preventing cement leakage via the anterior vertebral wall in Kümmell's patients treated with percutaneous kyphoplasty].

OBJECTIVE To evaluate the efficacy of gelfoam granules application in prevention of cement leakage via anterior vertebral wall in Kummell's patients treated with percutaneous kyphoplasty (PKP). METHODS From June 2017 to December 2019, 13 patients with Kummell disease were treated with PKP, and gelatin sponge was inserted into the anterior wall of vertebral body to prevent bone cement leakage. There were 3 males and 10 females, with an average age of (73.84±8.44) years. The visual analogue scale (VAS) was used to record the degree of pain before treatment and 1 day and 3 months after treatment; Oswestry Disability Index (ODI) was used to evaluate the thoracolumbar function before treatment and 3 monthsafter treatment;X-ray was used to observe the bone cement leakage after operation. RESULTS The VAS scores were 7.31±0.83, 2.92±1.13 and 1.69±1.11 before treatment and 1 day and 3 months after treatment, respectively. The VAS scores on the 1st day and 3 months after treatment were lower than those before treatment (P<0.05), and the postoperative pain was significantly relieved. The ODI before treatment and 3 months after treatment were (71.08±9.46)%, (17.85±7.82)%, respectively. The ODI at 3 months after treatment was improved compared with that before treatment (P<0.05), and the postoperative thoracolumbar function was significantly improved compared with that before treatment. Postoperative X-ray showed no leakage of bone cement in the anterior wall of vertebral body. CONCLUSION The application of gelfoam granules in PKP can effectively prevent the leakage of bone cement via the anterior vertebral wall of Kummell patients, and reduce the risk of thermal and mechanical injury of soft tissues such as the aorta in front of the vertebral body, and does not affect the postoperative pain relief and the recovery of thoracolumbar function.