D'Oria Salvatore, Delvecchio Carlo, Dibenedetto Mariagrazia, Zizza Francesco, Somma Carlo
Neurosurgical Unit of Miulli Hospital, Acquaviva delle Fonti, Italy.
Eur J Orthop Surg Traumatol. 2018 Feb;28(2):309-316. doi: 10.1007/s00590-017-2039-0. Epub 2017 Sep 14.
Kummell's disease is an avascular necrosis of the vertebral body, secondary to a vertebral compression fracture. This entity is characterised by the gradual development in time of a vertebral body collapse following a trivial spinal trauma, involving a worsening back pain associated with a progressive kyphosis.
The aim of this article is to carry out an international literature review regarding Kummell's disease, addressing its physiopathology, histopathology, clinical presentation, radiological characteristics and treatment modalities; at the same time, the literature is updated through the description of a new and interesting case, symbol of the pathology long-term potential complications, if not diagnosed and therefore not suitably treated.
A patient with osteoporosis, following a slight spinal trauma, suffered a progressive necrosis of the D11 body; although the radiological exams showed a constant worsening of the thoracic-lumbar kyphosis and a restriction of the spinal canal, in another medical centre he was only treated with a corset and painkillers. A year after the injury, motor deficits concerning the lower limbs appeared. He was then sent to us and indication for posterior internal fixation was given. On the basis of both his medical history and radiological and histological findings, Kummell's disease was diagnosed.
It is necessary to have a complete knowledge of the clinical, pathological and radiological characteristics of Kummell's disease, so as to follow a correct diagnostic course enabling to prepare the most suitable therapy.
Kummell病是椎体缺血性坏死，继发于椎体压缩性骨折。该疾病的特征是在轻微脊柱创伤后椎体塌陷随时间逐渐发展，伴有与进行性脊柱后凸相关的背痛加重。
本文旨在对Kummell病进行国际文献综述，阐述其生理病理学、组织病理学、临床表现、放射学特征及治疗方式；同时，通过描述一个新的有趣病例来更新文献，该病例是该病理长期潜在并发症的象征，若未被诊断且未得到适当治疗。
一名患有骨质疏松症的患者，在遭受轻微脊柱创伤后，发生了第11胸椎椎体的进行性坏死；尽管放射学检查显示胸腰段脊柱后凸持续加重且椎管狭窄，但在另一家医疗中心他仅接受了束腰和止痛药治疗。受伤一年后，出现了下肢运动功能障碍。随后他被转诊至我们这里，并接受了后路内固定治疗。根据其病史以及放射学和组织学检查结果，确诊为Kummell病。
有必要全面了解Kummell病的临床、病理和放射学特征，以便遵循正确的诊断流程，从而制定出最合适的治疗方案。
