Posttraumatic Delayed Vertebral Collapse :  Kummell’s Disease

Lim, Jeongwook; Choi, Sang Hee; Youm, Jin-Young; Kwon, Hyon-Jo; Kim, Seon‐Hwan; Koh, Hyun‐Moo

doi:10.3340/jkns.2017.0505.010

Cited by 71 publications

(84 citation statements)

References 37 publications

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“…MRI suggests limited fluid filling in the vertebral body. So Kümmell's disease is also referred to as delayed post-traumatic vertebral collapse disease, nonunion of vertebral fractures, and vertebral ischemic necrosis [1,2,17]. Previous studies have suggested that IVC is mainly located in the thoracolumbar region [4,18], which is similar to the segmental distribution of the two groups of patients in this study.…”

Section: Discussionsupporting

confidence: 73%

See 1 more Smart Citation

Comparison of the clinical outcomes of percutaneous vertebroplasty vs. kyphoplasty for the treatment of osteoporotic Kümmell’s disease:a prospective cohort study

Chang¹,

Bei

Shu³

et al. 2020

Preprint

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Background Percutaneous vertebroplasty (PVP) and percutaneous kyphoplasty (PKP) are widely used in the treatment of Kümmell's disease. The purpose of this article is to investigate the clinical efficacy of PVP and PKP for Kümmell's disease. Methods The clinical data that 56 cases of OVCF treated with either PVP (28 cases) or PKP (28 cases) and met the selection criteria from December 2015 to December 2017 were prospectively analyzed. Gender, age, course of disease, injury segment, BMD, VAS, ODI, imaging measurement indexes before surgery between the two groups showed no significant difference (all P>0.05). The bone cement leakage rate, bone cement injection amount, operation time, VAS, ODI, the rate of vertebral compression, correction rate of kyphosis and refracture rate of adjacent vertebra in 2 years were compared between the two groups to calculate clinical efficacy. Results The two groups were followed up for 24-48 months. There was no significant difference in the follow-up time, amount of bone cement injected, incidence of bone cement leakage and refracture rate of adjacent vertebra between the two groups (all P > 0.05). The operation time, intraoperative blood loss and fluoroscopy times of the PVP group were significantly lower than those of the PKP group (all P = 0.000). VAS score and ODI of the two groups were significantly lower at 1 d, 1 year and 2 years after surgery than before surgery (all P <0.05), but there was not statistically significant difference between the two groups at each time point after surgery (all P> 0.05). The rate of vertebral compression and kyphosis correction in the two groups were significantly corrected (P <0.05, respectively) and decreased significantly with time (all P <0.05), But there was not significant difference between the two groups at any time point (all P> 0.05). Conclusion Both PVP and PKP can achieve similar effects in the treatment of Kümmell's disease. Because the cost, operation time, blood loss, radiation exposure and surgical procedure of PVP are less than those of PKP, PVP has more clinical priority value.

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Section: Discussionsupporting

confidence: 73%

“…Kümmell's disease is a special type of osteoporotic vertebral compression fracture (OVCF), which is relatively rare in clinical practice [1]. Kümmell's disease is also known as nonunion after OVCF, delayed vertebral osteonecrosis after trauma, and delayed vertebral collapse [2,3].…”

Section: Introductionmentioning

confidence: 99%

Comparison of the clinical outcomes of percutaneous vertebroplasty vs. kyphoplasty for the treatment of osteoporotic Kümmell’s disease:a prospective cohort study

Chang¹,

Bei

Shu³

et al. 2020

Preprint

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“…Delayed posttraumatic spinal vertebral body collapse, namely Kummell disease, rst described by Dr. Hermann Kummell in 1985 is a rare and poorly documented disease [1,2]. By de nition, it is a spinal disorder characterized by patients suffered a minor spinal trauma but resulted in a symptomatic, progressive, angular kyphosis after a symptom-free period of time ranging from months to years [3,4].…”

Section: Introductionmentioning

confidence: 99%

A novel bone cement screw system combined with vertebroplasty for the treatment of Kummell disease with bone deficiency at vertebral anterior border: minimum 3-year follow-up study

Wang¹,

Zhang²,

Kong³

et al. 2020

Preprint

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Background: When vertebroplasty is used to treat Kummell disease with bone deficiency at vertebral anterior border, bone cement displacement often occurs intraoperative or postoperative. We designed and used a new bone cement screw system to avoid the serious complication. The purpose of this study is to evaluate the safety and effectiveness of this novel operation method through more than 3 years of follow-up. Methods: From January 2012 to August 2016, 27 patients suffering from single-segment Kummell disease with bone deficiency at vertebral anterior border were treated by vertebroplasty combined with novel bone cement screw. Bone cement is released into the diseased vertebrae through screw to fully fill the intravertebral vacuum cleft. Screw fixation of bone cement can avoid intraoperative or postoperative displacement. All patients were operated by unilateral technique, only one screw was implanted for each patient. The clinical efficacy was evaluated using Odom’s criteria and statistical analysis based on the results of vertebral body index (VBI), vertebral body angle (VBA), bisegmental Cobb angle (BCA), visual analogue scale (VAS), oswestry disability index (ODI), and the MOS 36-item short from health survey (SF-36). Results: The operation was completed successfully in 27 cases. The average operation time was 49.63±10.82 min, and the average volume of cement injected was 4.70±0.87 ml. The patients’ preoperative VBI, VBA, BCA, VAS and ODI scores were 43.11±5.94, 21.04±2.55, 45.00±6.26, 7.59±0.84, and 79.85±7.58, respectively. The postoperative measurements were 78.70±2.55, 12.70±2.11, 26.11±4.73, 3.22±0.93 and 50.04±9.28. At the last follow-up, the measurements were 78.04±2.30, 13.15±2.38, 27.07±4.87, 2.04±0.65, and 22.85±5.06, respectively. There was significant difference between the preoperative and postoperative data, as well as the preoperative and the last follow-up data (P<0.05). Compared the results of SF-36 preoperative and at the last follow-up, there were significant differences in physical function, role-physical, body pain, vitality, and social function these 5 items (P<0.05). However, there were no significant differences in general health, emotional function and mental health. Finally, 26 patients (96.3%) had good to excellent clinical outcomes according to Odom's criteria. Conclusions: This 3-year follow-up study shows that the novel bone cement screw system combined with vertebroplasty has a good short and medium-term therapeutic effect on patients with Kummell disease and bone deficiency at vertebral anterior border, while its long-term efficacy is subject to further studies.

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“…Herrnann Kümmell found in 1891 that patients had no symptoms for weeks to months after minor spinal trauma, but gradually developed into symptomatic, progressive kyphosis [1]. Chronic low back pain was not alleviated and progressively increased.…”

Section: Introductionmentioning

confidence: 99%

“…The most literatures reported that Kümmell's disease is associated with ischemic osteonecrosis and pseudoarthrosis formation [1,9,10]. There are obvious fissures and cavities in Kümmell's disease [11].…”

Section: Introductionmentioning

confidence: 99%

The clinical efficacy and experience of bipedicular percutaneous vertebroplasty combined with postural reduction in the treatment of Kümmell’s disease

Jiang

et al. 2020

BMC Musculoskelet Disord

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Background: Kümmell's disease is a special type of osteoporotic vertebral fracture that causes chronic low back pain and deformity, which seriously affects the living quality of patients. PVP is commonly used to treat osteoporotic vertebral fractures and can quickly relieve low back pain. So, the objective of this study was to analyze the clinical efficacy and experience of bipedicular percutaneous vertebroplasty combined with postural reduction for the treatment of Kümmell's disease. Methods: A retrospective analysis of patients with Kümmell's disease who underwent bipedicular percutaneous vertebroplasty was conducted from February 2016 to May 2018. Operative time, VAS, bone cement injection volume, cement leakage rate, compression improvement of vertebral front edge and vertebral center, and correction degree of kyphosis were collected and analyzed meticulously. Results: The operative time was 45.33 ± 7.64 min. The volume of bone cement injected was 5.38 ± 1.33 ml. The compression improvement of vertebral front edge was 7.31 ± 1.21%. The compression improvement of vertebral center was 10.34 ± 1.15% and the correction degree of kyphosis was − 2.73 ± 0.31゜. Bone cement leakage occurred in 6 of 39 patients (15.38%), but no clinical symptoms were observed. The VAS scores were significantly lower at 1 day after the surgery, 6 months and at the last follow-up than before the surgery (P = 0.000, respectively). The VAS score was lower at the last follow-up than at 1 day after the surgery (P = 0.001). Conclusion: Bipedicular percutaneous vertebroplasty combined with postural reduction could achieve satisfactory analgesic effect in the treatment of Kümmell's disease, and restore the height of the vertebral body and improve kyphosis to some extent.

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Posttraumatic Delayed Vertebral Collapse : Kummell’s Disease

Cited by 71 publications

References 37 publications

Comparison of the clinical outcomes of percutaneous vertebroplasty vs. kyphoplasty for the treatment of osteoporotic Kümmell’s disease:a prospective cohort study

Comparison of the clinical outcomes of percutaneous vertebroplasty vs. kyphoplasty for the treatment of osteoporotic Kümmell’s disease:a prospective cohort study

A novel bone cement screw system combined with vertebroplasty for the treatment of Kummell disease with bone deficiency at vertebral anterior border: minimum 3-year follow-up study

The clinical efficacy and experience of bipedicular percutaneous vertebroplasty combined with postural reduction in the treatment of Kümmell’s disease

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