Kummell Disease

Nickell, Larry T.; Schucany, William G; Opatowsky, Michael J.

doi:10.1080/08998280.2013.11928991

Cited by 13 publications

(14 citation statements)

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“…Ito et al [ 46 ] described the occurrence of ON in a patient with sarcoidosis. Other predisposing factors include cirrhosis, hyperuricemia, infection, and malignancy [ 1 , 47 ]. Table 1 summarizes the risk factors for VBON reported in the literature.…”

Section: Discussionmentioning

confidence: 99%

What is the Current Evidence on Vertebral Body Osteonecrosis?: A Systematic Review of the Literature

et al. 2018

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Osteonecrosis (ON) is a clinical entity characterized by a pattern of cell death and complex process of bone resorption and formation. Studies related to ON have largely focused on certain anatomical sites; however, the evidence on vertebral body ON (VBON) is largely inconsistent and fragmented. The aim of this study was to clarify the pathophysiology, risk factors, imaging findings, and available treatment modalities for VBON. A systematic review of the relevant articles published in English was performed using PubMed, Embase, Medline, Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL), and CINAHL databases. A total of 81 articles were included in this study. Three main topics about VBON were identified: (1) pathophysiology and risk factors, (2) diagnosis, and (3) treatment. Forty-five studies were based on the pathophysiology, 52 on diagnosis, and 38 on the treatment options for VBON. The literature on VBON was limited and mainly focused on post-traumatic cases with a considerable overlap with nonunion and pseudoarthrosis.

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Section: Discussionmentioning

confidence: 99%

What is the Current Evidence on Vertebral Body Osteonecrosis?: A Systematic Review of the Literature

et al. 2018

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“…Delayed post-traumatic vertebral collapse, or Kümmell disease, is marked by a painful kyphotic deformity that develops after an asymptomatic period of several weeks or months following an injury; it was first described by Hermann Kümmell in 1895 [ 1 ]. Symptoms may be absent for months to years after a minor trauma, but they can develop insidiously or suddenly.…”

Section: Introductionmentioning

confidence: 99%

Posterior Vertebrectomy and Circumferential Fusion for the Treatment of Advanced Thoracolumbar Kümmell Disease with Neurologic Deficit

Cho

2017

Asian Spine J

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Study DesignSingle-center, retrospective case series.PurposeTo investigate the effectiveness of posterior vertebrectomy and circumferential fusion in patients with advanced Kümmell disease with neurologic deficit.Overview of LiteratureVarious surgical options exist for the treatment of Kümmell disease, and determination of the appropriate treatment is based on the clinical and radiologic status of the patient. However, surgical intervention is required for patients with advanced Kümmell disease accompanied by neurologic deficit.MethodsWe retrospectively analyzed 22 neurologically compromised patients with advanced Kümmell disease who were treated surgically at Ewha Womans Hospital between January 2011 and January 2014. The surgical approach used by us was a posterior vertebrectomy with mesh cage insertion and segmental cement-augmented pedicle screw fixation. The tissue from the corpectomy was histopathologically examined. Anterior vertebral height, kyphotic angle, visual analog scale (VAS) score, and the Frankel classification were used to evaluate the efficacy of the procedure.ResultsThe mean follow-up period was 26 months (range, 13–40 months). VAS score, anterior vertebral height, kyphotic angle, and neurologic state were significantly improved immediately postoperatively and at the last follow-up compared with preoperatively (p<0.05). Most patients exhibited intravertebral clefts on imaging, and postoperative pathology revealed bone necrosis.ConclusionsPosterior vertebrectomy with mesh cage insertion and segmental cement-augmented pedicle screw fixation is an effective approach for treating patients with advanced Kümmell disease with neurologic deficit.

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“…Since Kümmell’s disease was first proposed by Hermann Kümmell in 1895,it has been gradually recognized and understood by spinal surgeons [ 1 ]. With the aging of the population, Kümmell’s disease,as a complication of osteoporotic vertebral compression fracture (OVCF) [ 2 – 5 ], also shows increased incidence [ 6 , 7 ]. At present, Kümmell’s disease is defined as ischemic necrosis of the vertebral body after minor spinal injury [ 5 , 6 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

“…With the aging of the population, Kümmell’s disease,as a complication of osteoporotic vertebral compression fracture (OVCF) [ 2 – 5 ], also shows increased incidence [ 6 , 7 ]. At present, Kümmell’s disease is defined as ischemic necrosis of the vertebral body after minor spinal injury [ 5 , 6 , 8 ]. As the disease progresses, the injured vertebra gradually collapse, and tend to become wedge shaped due to bone necrosis, followed by kyphosis deformity of the spine.…”

Section: Introductionmentioning

confidence: 99%

“…Previous theories of Kümmell’s disease suggest that there are two different types of pain, acute pain secondary to a fresh fracture at an early stage, and a chronic low back pain that develops gradually after a plateau of weeks or months [ 1 – 3 , 6 – 8 ]. As for the causes of chronic pain in the later stage, most of the literature indicates that it is due to bone necrosis, fracture nonunion, and instability caused by local micro-motion of the injured vertebra [ 6 , 7 , 9 , 11 , 14 ]. As the understanding of the spine sagittal balance has deepened, it has gradually been realized that a good spine sagittal balance could help the lower back muscles do a minimal work to maintain a balanced posture [ 22 , 23 ].…”

Section: Introductionmentioning

confidence: 99%

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Radiographic and clinical outcomes of surgical treatment of Kümmell’s disease with thoracolumbar kyphosis: a minimal two-year follow-up

Cheng

Wang

et al. 2021

BMC Musculoskelet Disord

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Background Up to now in the surgical treatment of Kümmell’s disease combined with thoracolumbar kyphosis, little research has focused on the evaluation of the imaging and clinical outcomes of restoring the normal alignment and sagittal balance of the spine. This study aimed to evaluate the short to mid-term radiographic and clinical outcomes in the treatment of Kümmell’s disease with thoracolumbar kyphosis. Methods From February 2016 to May 2018, 30 cases of Kümmell’s disease with thoracolumbar kyphosis were divided into group A and B according to whether the kyphosis was combined with neurological deficits. All of the cases underwent surgical treatment to regain the normal spinal alignment and sagittal balance. The radiographic outcomes and clinical outcomes of the cases were retrospectively evaluated. The sagittal imaging parameters including sagittal vertebral axis (SVA),thoracic kyphosis (TK),thoracolumbar kyphosis (TLK),lumbar lordosis (LL),pelvic incidence (PI),pelvic tilt (PT),and sacral slope (SS) before operation,immediately after operation,and the last follow-up of each case were measured and evaluated. The clinical results included the Oswestry Disability Index (ODI) and the Numerical Rating Scale (NRS) of the two groups. Statistical software SPSS21.0 was used to analyze the data. Results In group A: Mean SVA before operation was 75 mm and 26.7 mm at the final postoperative evaluation (P = 0.000); Mean TLK before operation was 39°, and 7.1° at the final postoperative evaluation (P = 0.000); Mean NRS before operation was 4.7, compared with 0.9 at the final postoperative evaluation (P = 0.000). In group B: Mean preoperative SVA was 62.5 mm and decreases to 30.7 mm at the final postoperative evaluation (P = 0.000); Mean TLK before operation was 33°, and 9.7° 2 years post-operation (P = 0.000); Mean NRS prior to surgery was 4.0, and 0.8 at the last follow-up evaluation (P = 0.000). The improvement of the NRS scores of groups A and B was related to the improvement of the cobb angle (P = 0.020); (P = 0.009) respectively. Conclusion In the treatment of Kümmell’s disease with thoracolumbar kyphosis,to restore the normal alignment and sagittal balance can obtain a satisfactory radiographic and clinical short and medium-term effects.

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Kummell Disease

Cited by 13 publications

References 4 publications

What is the Current Evidence on Vertebral Body Osteonecrosis?: A Systematic Review of the Literature

What is the Current Evidence on Vertebral Body Osteonecrosis?: A Systematic Review of the Literature

Posterior Vertebrectomy and Circumferential Fusion for the Treatment of Advanced Thoracolumbar Kümmell Disease with Neurologic Deficit

Radiographic and clinical outcomes of surgical treatment of Kümmell’s disease with thoracolumbar kyphosis: a minimal two-year follow-up

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