Karin Swartz1, Dominic Fee. 1. Departments of Neurosurgery, University of Kentucky, Chandler Medical Center, Lexington, KY, USA. karin.swartz@uky.edu
Abstract
STUDY DESIGN: A case report and literature review of Kümmell's disease. OBJECTIVE: To describe a case that meets modern criteria for Kümmell's disease and discuss the literature on this. SUMMARY OF BACKGROUND DATA: Over 100 years ago, Hermann Kümmell described a condition in which patients sustained a "trivial" trauma, had an essentially asymptomatic period lasting weeks to months, then developed a painful, progressive angular kyphosis. Only with the advent of radiograph technology, and the radiographic demonstration of delayed vertebral body collapse, was this concept felt to be valid. There has been a renewed interest in this as a diagnostic entity. METHODS: A patient is presented who developed worsening midback pain weeks after a minor fall. He subsequently was found to have T9, and T10 destructive vertebral body lesions. RESULTS: Only after an extensive workup, including 3 biopsies of the affected area was the diagnosis of Kümmell's disease considered and surgical treatment performed. CONCLUSION.: Delayed vertebral body collapse, i.e., Kümmell's disease, needs to be considered in any patient with recurrent or worsening spinal symptoms. Under-recognition of this condition leads to delayed diagnosis and treatment.
STUDY DESIGN: A case report and literature review of Kümmell's disease. OBJECTIVE: To describe a case that meets modern criteria for Kümmell's disease and discuss the literature on this. SUMMARY OF BACKGROUND DATA: Over 100 years ago, Hermann Kümmell described a condition in which patients sustained a "trivial" trauma, had an essentially asymptomatic period lasting weeks to months, then developed a painful, progressive angular kyphosis. Only with the advent of radiograph technology, and the radiographic demonstration of delayed vertebral body collapse, was this concept felt to be valid. There has been a renewed interest in this as a diagnostic entity. METHODS: A patient is presented who developed worsening midback pain weeks after a minor fall. He subsequently was found to have T9, and T10 destructive vertebral body lesions. RESULTS: Only after an extensive workup, including 3 biopsies of the affected area was the diagnosis of Kümmell's disease considered and surgical treatment performed. CONCLUSION.: Delayed vertebral body collapse, i.e., Kümmell's disease, needs to be considered in any patient with recurrent or worsening spinal symptoms. Under-recognition of this condition leads to delayed diagnosis and treatment.
Authors: Salvatore D'Oria; Carlo Delvecchio; Mariagrazia Dibenedetto; Francesco Zizza; Carlo Somma Journal: Eur J Orthop Surg Traumatol Date: 2017-09-14