Kümmell’s Disease

Swartz, Karin R.; Fee, Dominic B.

doi:10.1097/brs.0b013e3181657f31

Cited by 57 publications

(43 citation statements)

References 21 publications

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“…Thus, it is important to obtain the diagnosis of vertebral ON prior to making a decision on treatment, since it should be taken into consideration. Currently, vertebral ON remains a radiographic diagnosis, but most studies correlated the histopathology and image finding from percutaneous needle biopsy [4,25,26]. To the best of our knowledge, only Baur et al [27] reported the histological comparison of fluid sign in four osteoporotic and one metastatic fracture by open retrieval of specimen from surgery.…”

Section: Discussionmentioning

confidence: 99%

“…The possible pathogenesis is disruption of the blood supply related to fracture and inadequate revascularization of bone marrow [4,28]. Besides, increased marrow pressure caused by intramedullary hemorrhage leads to increased adipocyte size with a proportionate decrease in intraosseous blood flow, also predisposing patients to ischemic necrosis of the vertebral body [29].…”

Section: Discussionmentioning

confidence: 99%

“…More recently, Kummell's disease has been felt to represent the vertebral body collapse after a minor trauma seemingly because of osteonecrosis (ON) [4,6]. This definition most likely arises from the work of Schmorl and Junghanns on the basis of histopathologic analysis at autopsy of patients with posttraumatic vertebral collapse, suggested that Kummell's disease is caused by ischemia [10].…”

Section: Introductionmentioning

confidence: 99%

“…The majority of these fractures heals uneventfully with conservative treatment with a mild backache as a residual. However, some of these patients continue to experience pain or neurological deficits: some of them may have developed delayed posttraumatic osteonecrosis [4][5][6]. The understanding of the natural history of vertebral fracture remains challenging because the healing potential is influenced by a variety of biochemical, biomechanical, cellular, and pathological mechanisms [7].…”

Section: Introductionmentioning

confidence: 99%

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MRI fluid sign is reliable in correlation with osteonecrosis after vertebral fractures: a histopathologic study

Lin

Huang

et al. 2012

Eur Spine J

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Introduction Magnetic resonance images (MRI) fluid sign and intravertebral vacuum phenomenon of the plain radiograph are considered as the characteristic radiological findings for vertebral osteonecrosis after spinal fractures. We aim to study the association between the radiological and histopathologic findings of vertebral osteonecrosis through the use of an open retrieval of specimens. Materials and methods Twenty consecutive patients (54-84 years, mean 73 years) of unstable vertebral compression fractures treated with anterior corpectomy and fusion were included. All the images and pathologies were correlated, especially the histopathologic changes to the fluid sign and vacuum phenomenon.Results MRI fluid signs and the histopathologic findings of vertebral osteonecrosis were significantly correlated and both were noted in the first 5 months after injury. The power of the fluid sign in diagnosing vertebral osteonecrosis was better than that of the intravertebral vacuum phenomenon (diagnostic odds ratio 65 vs. 2, sensitivity 86 vs. 50 %, specificity 100 vs. 67 %). Conclusion MRI fluid sign is more predictable to diagnose vertebral osteonecrosis in operative case, especially within the initial 5 months after injury.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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MRI fluid sign is reliable in correlation with osteonecrosis after vertebral fractures: a histopathologic study

Lin

Huang

et al. 2012

Eur Spine J

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“…The delayed fashion of the VBC is generally explained by the prevailing hypothesis of ischemic necrosis [2]. This association of KD with osteonecrosis, however, and further connection with specific radiographic findings (intraverte-bral vacuum cleft) has led many authors in wrongly reporting patients with other pathologies, as having KD [3, 4]. On the contrary, KD originally involves patients, without any predisposing disorder for ischemic necrosis, other than trauma [5].…”

Section: Introductionmentioning

confidence: 99%

Kümmell’s Disease: Clarifying the Mechanisms and Patients’ Inclusion Criteria

Matzaroglou

Georgiou

Panagopoulos

et al. 2014

TOORTHJ

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The three major causes of vertebral body collapse include infection, malignant neoplasia, and trauma and it may be difficult to distinguish between them, particularly in the presence of severe osteoporosis. In 1891, however, Dr Hermann Kümmell, further added another possibility of vertebral body crush; the delayed posttraumatic collapse. As originally described, this rare clinical entity includes patients, who after a trivial trauma and an asymptomatic clinical course they develop a progressive vertebral body collapse and a painful kyphosis. Although more than a century has passed from its initial description, only few cases have been reported in the literature, whereas the main pathologic eliciting event is still under investigation. As a consequence, great controversy exists regarding the discrete features of the clinical course, its radiographic appearance and the histopathological findings. To explain the time lag between the initial trauma and the occurrence of the vertebral collapse, the hypothesis of ischemic necrosis was advanced. Equation of Kümmell’s disease with vertebral osteonecrosis, however, has wrongly led many authors to report cases of Kümmell’s disease, even in the absence of history of spinal trauma. On the other hand, high coincidence of vertebral osteonecrosis and the pathognomonic radiographic finding of intravertebral vacuum cleft, has further added to the confusion. In this review we present an overview of the literature on Kümmell’s disease, focusing on the different proposed eliciting mechanisms. We also highlight controversial subjects on clinical course, diagnosis and treatment of this entity, in an attempt to further clarify patients’ inclusion criteria.

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Minimally Invasive Reconstruction of Vertebral Body in Kümmell’s Disease

Lee

Bae

2020

Minimally Invasive Thoracic Spine Surgery

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Kümmell’s Disease

Cited by 57 publications

References 21 publications

MRI fluid sign is reliable in correlation with osteonecrosis after vertebral fractures: a histopathologic study

MRI fluid sign is reliable in correlation with osteonecrosis after vertebral fractures: a histopathologic study

Kümmell’s Disease: Clarifying the Mechanisms and Patients’ Inclusion Criteria

Minimally Invasive Reconstruction of Vertebral Body in Kümmell’s Disease

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