J Korean Soc Spine Surg.  2001 Sep;8(3):226-234. 10.4184/jkss.2001.8.3.226.

Kummell's Disease Managed by Percutaneous Vertebroplasty

• Cho YS
• Cho SD
• Kim BS
• Park TW
• Lew S
• Hwang SY

• KMID: 2209739
• DOI: http://doi.org/10.4184/jkss.2001.8.3.226

Abstract

STUDY DESIGN: Prospective study about fourteen consecutive patients with Kummell's disease who were treated by percutaneous vertebroplasty with bone cement.
OBJECTIVES
To evaluate the results of percutaneous vertebroplasty using bone cement in the treatment of Kummell's disease. SUMMARY OF LITERATURE REVIEW: Kummell's disease is a rarely reported, poorly documented, and poorly understood phenomenon. It is associated with intravertebral vacuum phenomenon and clinically manifested by painful kyphosis. The treatment of the disease had been conservative or surgical reconstruction, but both conservative and operative treatment were not satisfactory in some patients.
MATERIALS AND METHODS
A review was conducted of 14 patients with 18 vertebrae treated with percutaneous vertebroplasty from June 1999 to May 2000. They had posttraumatic vertebral collapse or Kummell's disease and had failed medical therapy. Immediate and long-term pain response and complications of percutaneous vertebroplasty with bone cement were evaluated.
RESULTS
All patients reported complete relief of pain within the first 24 hours. Ten(71.5%) were evaluated as excellent; three(21.4%), good; one(7.1%), fair until 3 months postoperatively. Eight(57.2%) were evaluated as excellent; four(28.6%), good; fair(7.1%), one; poor(7.1%), one at final follow-up. Five(35.7%) patients had cement extrusion into the disc, paravertebral vessels and epidural space without significant systemic symptoms.
CONCLUSIONS
For patients with posttraumatic vertebral collapse or Kummell's disease, percutaneous vertebroplasty technique using bone cement would be a minimally invasive treatment option to achieve immediate relief of pain and stabilization without significant side effects.

Keyword

Kummell's disease; Percutaneous vertebroplasty

MeSH Terms

Epidural Space
Follow-Up Studies
Humans
Kyphosis
Prospective Studies
Spine
Vacuum
Vertebroplasty*

Figure

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  Fig. 1. Initial AP and lateral radiographs (A) show no evidence of compression fracture, but the bone scan shows increased uptake on T12(B). Radiographs taken three months later show severe wedging of T12 and intravertebral gas shadow(C). After vertebroplasty, bone cement is well visualized in the T12 vertebral body with a leak into the T12-L1 disc space (D).

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  Fig. 2. Lateral radiograph (A) and CT (B) showing wedging of vertebral body and intravertebral gas. CT scans after vertebroplasty (C). Needle biopsy during vertebroplasty demonstrated ischemic necreosis of bone without evidence of bone regeneration (D). Kyphosis improved immediately vertebroplasty, but increased gradually after 2 years (E, F).

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  Fig. 3. CT scans taken immediately (A) and one year later (B) after vertebroplasty. The interface between bone and cement is well maintained without resoption of bone.

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