Kümmell's Disease, an Uncommon and Complicated Spinal Disorder: A Review

• Published in: Journal of international medical research Vol. 40; no. 2; pp. 406 - 414
• Main Authors: Li, H, Liang, C-Z, Chen, Q-X
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.04.2012
• Subjects: Disease Progression; Humans; Kyphosis - diagnostic imaging; Kyphosis - surgery; Osteonecrosis - complications; Osteonecrosis - diagnostic imaging; Osteonecrosis - pathology; Radiography; Spinal Cord Compression - complications; Spinal Cord Compression - diagnostic imaging; Spinal Cord Compression - surgery; Spinal Fractures - diagnostic imaging; Spinal Fractures - etiology; Spinal Fractures - surgery; Spine - diagnostic imaging; Spine - pathology; Spine - surgery; Thoracic Vertebrae - diagnostic imaging; Thoracic Vertebrae - injuries; Thoracic Vertebrae - surgery; Kyphosis; Review; Kümmell's Disease; Spinal Deformity
• ISSN: 0300-0605; 1473-2300
• DOI: 10.1177/147323001204000202

Kümmell's disease is an uncommon and complicated spinal condition first described in 1891. Patients develop a kyphosis in the lower thoracolumbar spinal region months to years after sustaining an otherwise asymptomatic minor spinal trauma. The pathophysiology, clinical presentation, imaging and treatment options of this disease remain controversial. The most widely accepted hypothetical pathophysiology is avascular osteonecrosis. The intravertebral vacuum cleft phenomenon is considered a radiographic sign of avascular osteonecrosis of the vertebral body and is highly suggestive of Kümmell's disease. Treatment options include nonsurgical and surgical treatment, and percutaneous vertebral augmentation. The primary aims of surgical treatment of Kümmell's disease are neural decompression and stabilization of the spinal column. Surgery can involve an anterior, posterior, or combined anterior and posterior approach. Surgery and percutaneous vertebral augmentation provide significant symptomatic relief, functional improvement and deformity correction. Treatment of this disease must be individualized according to the stage of disease and the experience and preference of the surgeon.