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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 longterm pain response and complications of percutaneous vertebroplasty with bone cement were evaluated.
Resul t s
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 followup. Five(35.7%) patients had cement extrusion into the disc, paravertebral vessels and epidural space without significant systemic symptoms.
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Figures and Tables%
 | 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). |
 | 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). |
 | 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. |
Table 1.
Evaluation of Results
| Excellent; Complete relief of pain |
| Good; Intermittent pain without medication |
| Fair; Intermittent pain with medication |
| Poor; No or little relief of pain |
Table 2.
Summary of cases.
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