PT  - JOURNAL ARTICLE
AU  - Bae, Junseok
AU  - Ang, Chay-you
AU  - Syed, Ifthekar
AU  - Jeong, Seong Kyun
AU  - Shin, Sang Ha
AU  - Lee, Sang-Ho
TI  - Minimally Invasive Surgery Transpedicular Intrabody Cage Technique for the Management of Kummell Disease
AID  - 10.14444/8570
DP  - 2024 Jan 30
TA  - International Journal of Spine Surgery
PG  - 8570
4099  - https://www.ijssurgery.com/content/early/2024/01/24/8570.short
4100  - https://www.ijssurgery.com/content/early/2024/01/24/8570.full
AB  - Background The treatment of Kummell disease remains controversial, with a wide variety of options proposed in the literature. This study aims to introduce a unique and minimally invasive approach for the treatment of Kummell disease and present the clinical results of this technique.Methods Twenty patients underwent surgery using the minimally invasive surgery transpedicular intrabody cage (MISTIC) technique from 2014 to 2016. Postoperatively, patients were seen at 3, 6, and 12 months after surgery. Visual analog scale and Oswestry Disability Index scores were collected, and patient outcomes were graded according to the modified MacNab’s criteria. Radiological outcomes were assessed through measurements of the anterior vertebral height (AH), mean vertebral body height (BH), and segmental angle (SA) on standing lateral radiographs pre- and postoperatively.Results There was significant improvement in the SA, AH, and BH postoperatively. The SA improved from 15.2 ± 8.7° of kyphosis to 1.2 ± 5.2° (P < 0.01) in the immediate postoperative period. The AH increased from 13.3 ± 14.6 to 22.6 ± 12.2 mm (P < 0.01), and at the final follow-up, it was 21.9 ± 12.6 mm (P < 0.01). Similarly, the BH increased from 18.5 ± 6.8 to 25.6 ± 7.6 mm (P < 0.01) postsurgery, and at the final follow-up, it was 23.6 ± 4.4 mm (P < 0.01).Conclusions The MISTIC technique offers significant correction of kyphosis and restoration of the vertebral anatomy following surgery. These results were maintained at 12 months postoperation, with a 100% union rate of the fractures. Additionally, patients experienced significant pain relief and improvement in their ODI scores that were maintained at 12 months.Level of Evidence 4.