Impending cauda equina syndrome due to Kummell disease; A case report and literature review

Omidi-Kashani, Farzad; Parsa, Ali; Daniel, Madarshahian

doi:10.1016/j.ijscr.2021.106041

Cited by 3 publications

(1 citation statement)

References 14 publications

(33 reference statements)

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“…The main purpose of surgery is to relieve the nerve compression and the back pain in the patient. Therefore, the surgical method is decompression and fixation fusion ( 26 , 27 ). Lee et al reported that 10 patients with Kümmell disease and neural symptoms underwent posterior decompression, fixation, and fusion.…”

Section: Discussionmentioning

confidence: 99%

Analysis of strategy and efficacy clinical treatments of Kümmell disease: a cohort study

Xu¹,

Ding²,

Xu³

et al. 2022

Ann Transl Med

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Background: Most clinical reports on the surgical treatment of kümmell disease lack consistency between classification and treatment protocol. In this study, we investigate the most appropriate and effective clinical treatment strategies according to the characteristics of different types of Kümmell disease.Methods: A retrospective analysis was performed of 48 patients with Kümmell disease treated in Tongde Hospital of Zhejiang Province, Hangzhou, Zhejiang, China for which complete follow-up data were available. All cases were classified into six types: type I, vertebral body height loss less than 20% and no intervertebral disc degeneration from adjacent segments; type II, vertebral body height loss more than 20% and accompanied by degeneration or mild instability of intervertebral discs at adjacent segments; type III, posterior vertebral cortical rupture and dural sac compression, and some accompanied by spinal cord nerve injury. Type III includes type IIIA (recoverable stable type), type IIIB (recoverable unstable type), type IIIC (spinal stenosis type), and type IIID (kyphosis type). Methods of surgery: patients of types I, II, and IIIA were treated with percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP), type IIIB were treated with posterior fixation and fusion, type IIIC were treated with posterior decompression and fixation fusion, and type IIID were treated with posterior osteotomy, orthopedic fixation, and fusion. All patients were followed up for 10-44 months (mean, 20.5±4.5 months). The preoperative and postoperative visual analog scale (VAS) scores, Owestry disability index (ODI) scores, secondary height loss and kyphosis, and neurological improvement were followed up and statistically analyzed. Results:The VAS and ODI scores of all cases were improved compared with those pre-surgery (P<0.05).A total of 8 cases showed loss of vertebral height or secondary kyphosis. The American Spinal Injury Association (ASIA) grades of patients with neural impairment were all improved at the last follow-up.Conclusions: According to the characteristics of different types of Kümmell disease, appropriate clinical treatment strategies can achieve satisfactory curative effects and reduce the occurrence of complications.This study is only a retrospective study, lacks a control group, and the sample size is small. Therefore, it has limitations and does not provide guidance.

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Section: Discussionmentioning

confidence: 99%

Analysis of strategy and efficacy clinical treatments of Kümmell disease: a cohort study

Xu¹,

Ding²,

Xu³

et al. 2022

Ann Transl Med

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Spinal Pathologic Fractures

Akhaddar

2023

Atlas of Sciatica

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Strategies in the Management of Osteoporotic Kummell’s Disease

Kuppan¹,

Muthu²,

Parthasarathy³

et al. 2022

JOCR

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Introduction: Kummell disease is a condition characterized by severe pain, progressing kyphosis with or without neurological deficit following a trivial trauma in the old age osteoporotic population. It is an osteoporotic vertebral fracture due to avascular necrosis of the vertebra, having an asymptomatic period initially followed by progressive pain, kyphosis, and neurologic deficit. Although various management options are available for Kummell’s disease, a dilemma occurs in selecting an optimal modality in each case. Case Report: A 65-year-old female presented with complaints of low back pain for 4 weeks. She developed progressive weakness and bowel bladder disturbance. Radiographs showed a D12 vertebral compression fracture with an intravertebral vacuum cleft sign. Magnetic resonance imaging showed intravertebral fluid and significant compression of the cord. We performed posterior decompression, stabilization, and transpedicular bone grafting at the D12 level. Histopathology confirmed Kummell’s disease. The patient recovered with restored power and bladder control and resumed independent ambulation. Conclusion: Osteoporotic compression fractures are more prone to pseudoarthrosis due to poor vascular and mechanical support, they need adequate immobilization and bracing. Transpedicular bone grafting for kummels disease seems to be a good surgical option due to its short operating time, less bleeding, less invasive approach, and early recovery. However, a treatment-oriented classification is needed to treat this clinical entity on a case-by-case basis. Keywords: Kummell’s disease, osteoporosis, kyphoplasty, transpedicular bone grafting, spine.

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Impending cauda equina syndrome due to Kummell disease; A case report and literature review

Cited by 3 publications

References 14 publications

Analysis of strategy and efficacy clinical treatments of Kümmell disease: a cohort study

Analysis of strategy and efficacy clinical treatments of Kümmell disease: a cohort study

Spinal Pathologic Fractures

Strategies in the Management of Osteoporotic Kummell’s Disease

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