Kummell’s disease treated with posterior instrumented stabilization and transpedicular biopsy: A case series

Abstract

Kummell’s disease is avascular necrosis of vertebral body caused by a vertebral compression fracture. It is an osteonecrosis-related disease that can cause severe vertebral collapse, with severe pain, and may progress to kyphosis and neurological deficit. In this case series, we have reported five cases of Kummell’s disease. All the five patients were preoperatively bedridden due to pain in low back while mobilizing. Case 1 complained of low back pain radiating to left lower limb and had neurological deficits in L5 myotome. Other four cases complained of axial type of low back pain. All five patients underwent posterior instrumented stabilization and transpedicular aspiration of fluid along with biopsy; they were diagnosed as Kummell’s disease by exclusion. Postoperatively all five patients improved symptomatically and were able to walk with assistance. We found that posterior instrumented stabilization offered good patient-related outcomes in terms of pain and postoperative rehabilitation on short-term follow-up. Kummell’s disease is overlooked on X-ray when a patient presents at an early stage and hence a thorough knowledge of Kummell’s disease is required for the early treatment of these patients and prevention of complications.

Keywords

• kummell’s disease
• posterior instrumented stabilization
• transpedicular biopsy