|
KMID : 0614720210640110753
|
|
Journal of Korean Medical Association
2021 Volume.64 No. 11 p.753 ~ p.762
|
|
|
Treatment of Kummell’s disease following the occurrence of osteoporotic vertebral compression fracture
|
|
Park Se-Jun
|
|
|
Abstract
|
|
|
Background: The incidence of osteoporotic vertebral compression fracture (OVCF) is increasing with the increase in the elderly population. Kummell’s disease following OVCF occurrence is not a rare complication and is frequently associated with severe pain or neurologic deficit with progressive kyphotic deformity. Kummell’s disease initially meant post-traumatic delayed vertebral collapse, but now it is also termed nonunion, osteonecrosis, or intravertebral vacuum cleft, all of which suggest the disruption of the healing process.
Current Concepts: The major pathogenesis of Kummell’s disease is a vascular compromise caused by mechanical stress or intravascular pathology. The key radiologic sign to diagnose Kummell’s disease is the presence of intravertebral vacuum cleft, observed using simple X-ray, computed tomography, or magnetic resonance imaging. Magnetic resonance imaging is the most useful diagnostic tool showing gas or fluid signals. The risk factors for the progression of Kummell’s disease after OVCF include middle-column injury, confined low signal intensity on T2-weighted image, posterior wall combined fracture, kyphotic angle >10°, and a height loss >15%.
Its treatment can be broadly classified as conservative treatment, bone cement injection, and surgical treatment.
The appropriate treatment method is selected based on the pain intensity, neurological symptoms, and the severity of the kyphotic deformity.
Discussion and Conclusion: Kummell’s disease usually develops along with osteoporosis. Therefore, the treatment should be focused on relief from symptoms associated with Kummell’s disease and osteoporosis.
It is recommended that an anabolic agent should be administered after the diagnosis of Kummell’s disease, regardless of the treatment modality.
|
|
|
KEYWORD
|
|
|
Spinal diseases, Osteoporotic fractures, Compression fractures, Osteonecrosis
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
 
|
|