![]() Pappou IP, Papadopoulos EC, Swanson AN, Cammisa FP, Girardi FP. (2010) Kummell\'s disease: delayed post-traumatic osteonecrosis of the vertebral body. (2011) Kümmell\'s disease: pathophysiology, diagnosis, treatment and the role of nuclear medicine. Matzaroglou C, Georgiou CS, Assimakopoulos K, Giannakenas C, Karageorgos A, Saridis A, Kafchitsas K, Wilke HJ. (2002) Delayed post-traumatic osteonecrosis of a vertebral body (Kummell\'s disease). Young WF, Brown D, Kendler A, Clements D. ![]() Surgical treatment usually consists of vertebroplasty or kyphoplasty, with anterior and / or posterior decompression and stabilization surgery being performed when there is neurological compromise. Surgery has been shown to be the most effective treatment, providing better kyphosis correction, better biomechanical stability and earlier patient ambulation. This treatment approach should be tried only in the absence of neurological impairment and in patients with an intact posterior vertebral body wall. The conservative therapy usually consists of analgesia, rest and the use of an external support device. The treatment options are conservative therapy and surgical intervention. The most accepted mechanism of its formation is a combination of avascular necrosis and pseudarthrosis of the non-consolidated vertebral body fracture. Its association with Kummell’s disease is also not well defined. The intravertebral vacuum cleft is an area of radiolucency caused by the presence of intravertebral gas. Avascular necrosis caused by disruption of the vertebral body arterial supply seems to be the most accepted mechanism. This condition's pathogenesis is not yet well known, but it seems to represent a failure of the vertebral fracture healing process. Finally, there is kyphotic spine deformity caused by vertebral collapse and possible neurological impairment, with variable degrees of parestesia, muscle weakness and loss of sphincter control. In the fourth stage there is recurrence of back pain, with possible development of nerve root compression and its associated peripheral pain. The third stage is a period of general well-being, completely asymptomatic or with minor symptoms, with its duration ranging from 4 weeks to 1 year. Then follows a period of minor symptoms that don't interfere with daily activities. A series of five clinical stages have been described for this condition : first, after the initial trauma, there is back pain while the radiographic and CT studies are negative. Kummell’s disease is most prevalent in middle-aged and older patients. Kummell’s disease was first described by Kummell in 1895, who reported a series of patients presenting with delayed vertebral collapse after seemingly minor trauma. The key diagnostic features for Kummell’s disease are development of delayed vertebral collapse with intravertebral vacuum cleft after an initial minor trauma, observed only in serial examinations.
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