A technical note on the posterior approach BDBO for treating Kümmell disease.

Abstract

To evaluate the therapeutic efficacy of bone-disc-bone osteotomy (BDBO) via a posterior approach in combination with biomimetic bone grafting and pedicle screw implantation for the treatment of Kümmell disease complicated with kyphosis. Between March 2012 and June 2020, we retrospectively analyzed 22 patients who had Kümmell disease complicated with kyphosis and underwent BDBO in combination with biomimetic bone grafting and pedicle screw implantation. The kyphotic Cobb angle, visual analog scale (VAS), Oswestry Disability Index (ODI), and American Spinal Injury Association (ASIA) Impairment Scale were used to evaluate the effects of surgery. In addition, surgical conditions, including duration of surgery, intraoperative blood loss, and surgical complications, were recorded. The mean follow-up time was 32.86 months (range, 28.27 to 36.67). The mean operative time was 176.68 ± 25.96 min and the mean intraoperative blood loss was 281.24 ± 43.26 mL. The VAS, ODI, and kyphotic Cobb angles were significantly improved 1 week after surgery compared with preoperative assessments and remained well maintained at final follow-up. Eight patients (36.4%) had mild neurologic impairment before surgery, and their neurologic function normalized at final follow-up. The rate of intervertebral fusion at the final follow-up was 100%. One patient (4.5%) had an infected incision that healed after debridement. There was no case of instrumentation failure. BDBO in combination with biomimetic bone grafting and pedicle screw implantation is a novel, safe, effective and elective treatment strategy for patients who experienced Kümmell disease complicated by kyphosis.