Kummell's Disease, Case Report of a Delayed Onset Paraparesis and Literature ReviewSalvatore D'Oria*, Carlo Delvecchio, Francesco Zizza, Carlo Somma
Neurosurgical Unit of Miulli Hospital of Acquaviva delle Fonti, Bari, Italy
- *Corresponding Author:
- Salvatore D'Oria
Department of Neurosurgery
Second University of Naples
E-mail: [email protected]
Received date: March 18, 2016; Accepted date: March 28, 2016; Published date: April 03, 2017
Citation: D'Oria S, Delvecchio C, Zizza F, Somma C. Kummell's Disease, Case Report of a Delayed Onset Paraparesis and Literature Review. Journal of Surgery [Jurnalul de chirurgie]. 2017; 13(1): 17-24 DOI: 10.7438/1584-9341-13-1-4
Copyright: © 2017 D'Oria S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Introduction: Kummell's disease is an avascular necrosis of the vertebral body, secondary to a vertebral compression fracture. This entity is characterized by the gradual development in time of a vertebral body collapse following a trivial spinal trauma, involving a worsening back pain associated to a progressive kyphosis. Following the progressively ageing population the prevalence of osteoporosis is increasing and as a consequence, the incidence of spinal crush fractures; therefore evidence of Kummell's disease is quite common, also favoured by the great accuracy of modern diagnostic equipment. Purposes: 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, 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. Case report: 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. Conclusion: Is necessary to have a complete knowledge of the clinical, pathological and radiological characteristics of Kummell's disease, as to follow a correct diagnostic course enabling to prepare the most suitable therapy.