Skip to main content
Top
Published in: MUSCULOSKELETAL SURGERY 3/2017

01-12-2017 | Original Article

Corpectomy and circumferential fusion for advanced thoracolumbar Kümmell’s disease

Author: Y. Cho

Published in: MUSCULOSKELETAL SURGERY | Issue 3/2017

Login to get access

Abstract

Background

The aim of this study was to investigate the surgical treatment of neurologically compromised advanced Kümmell’s disease. The surgical treatment of Kümmell’s disease has various options according to clinical and radiologic status. Far collapsed Kümmell’s disease patients with neurological deficit need to be treated surgically.

Materials and methods

We retrospectively analyzed 22 patients operated to our hospital with neurologically compromised Kümmell’s disease between January 2011 and January 2014. Surgical approach was vertebrectomy, mesh cage insertion and segmental cement-augmented pedicle screw fixation. Corpectomy tissue was examined histopathologically. Anterior vertebral heights, kyphotic angle, the visual analog scale (VAS) and the Frankel classification were used to evaluate the effects of the surgery.

Results

The mean time of follow-up was 26 months (range, 13–40 months). The VAS, anterior vertebral heights, kyphotic angle and neurological state were improved significantly immediate postoperatively and at the last follow-up compared with the preoperative examinations (P < 0.05). Most of the patients in this study exhibited intravertebral clefts, and postoperative pathology revealed bone necrosis.

Conclusion

Posterior vertebrectomy with mesh cage insertion and segmental cement-augmented pedicle screw fixation is an effective option for advanced Kümmell’s disease with neurological deficits.
Literature
1.
go back to reference Nickell LT, Schucany WG, Opatowsky MJ (2013) Kummell disease. Proc (Bayl Univ Med Cent) 26(3):300–301 Nickell LT, Schucany WG, Opatowsky MJ (2013) Kummell disease. Proc (Bayl Univ Med Cent) 26(3):300–301
2.
go back to reference Linn J, Birkenmaier C, Hoffmann RT, Reiser M, Baur-Melnyk A (2009) The intravertebral cleft in acute osteoporotic fractures: fluid in magnetic resonance imaging-vacuum in computed tomography? Spine (Phila Pa 1976) 34(2):E88–E93CrossRef Linn J, Birkenmaier C, Hoffmann RT, Reiser M, Baur-Melnyk A (2009) The intravertebral cleft in acute osteoporotic fractures: fluid in magnetic resonance imaging-vacuum in computed tomography? Spine (Phila Pa 1976) 34(2):E88–E93CrossRef
3.
go back to reference Oka M, Matsusako M, Kobayashi N, Uemura A, Numaguchi Y (2005) Intravertebral cleft sign on fat-suppressed contrast-enhanced MR: correlation with cement distribution pattern on percutaneous vertebroplasty. Acad Radiol 12(8):992–999CrossRefPubMed Oka M, Matsusako M, Kobayashi N, Uemura A, Numaguchi Y (2005) Intravertebral cleft sign on fat-suppressed contrast-enhanced MR: correlation with cement distribution pattern on percutaneous vertebroplasty. Acad Radiol 12(8):992–999CrossRefPubMed
4.
go back to reference Wu AM, Ni WF, Weng W, Chi YL, Xu HZ, Wang XY (2012) Outcomes of percutaneous kyphoplasty in patients with intravertebral vacuum cleft. Acta Orthop Belg 78(6):790–795PubMed Wu AM, Ni WF, Weng W, Chi YL, Xu HZ, Wang XY (2012) Outcomes of percutaneous kyphoplasty in patients with intravertebral vacuum cleft. Acta Orthop Belg 78(6):790–795PubMed
5.
go back to reference Wu AM, Chi YL, Ni WF (2013) Vertebral compression fracture with intravertebral vacuum cleft sign: pathogenesis, image, and surgical intervention. Asian Spine J 7(2):148–155CrossRefPubMedPubMedCentral Wu AM, Chi YL, Ni WF (2013) Vertebral compression fracture with intravertebral vacuum cleft sign: pathogenesis, image, and surgical intervention. Asian Spine J 7(2):148–155CrossRefPubMedPubMedCentral
6.
go back to reference Osterhouse MD, Kettner NW (2002) Delayed posttraumatic vertebral collapse with intravertebral vacuum cleft. J Manipulative Physiol Ther 25(4):270–275CrossRefPubMed Osterhouse MD, Kettner NW (2002) Delayed posttraumatic vertebral collapse with intravertebral vacuum cleft. J Manipulative Physiol Ther 25(4):270–275CrossRefPubMed
7.
go back to reference Zhang X, Hu W, Yu J, Wang Z, Wang Y (2016) An effective treatment option for Kummell disease with neurological deficits: modified transpedicular subtraction and disc osteotomy combined with long-segment fixation. Spine (Phila Pa 1976) 41(15):E923–E930CrossRef Zhang X, Hu W, Yu J, Wang Z, Wang Y (2016) An effective treatment option for Kummell disease with neurological deficits: modified transpedicular subtraction and disc osteotomy combined with long-segment fixation. Spine (Phila Pa 1976) 41(15):E923–E930CrossRef
8.
go back to reference Nakamae T, Fujimoto Y, Yamada K, Hashimoto T, Olmarker K (2015) Efficacy of percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures with intravertebral cleft. Open Orthop J 9:107–113CrossRefPubMedPubMedCentral Nakamae T, Fujimoto Y, Yamada K, Hashimoto T, Olmarker K (2015) Efficacy of percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fractures with intravertebral cleft. Open Orthop J 9:107–113CrossRefPubMedPubMedCentral
9.
go back to reference Capaul M, Zollinger H, Satz N, Dietz V, Lehmann D, Schurch B (1994) Analyses of 94 consecutive spinal cord injury patients using ASIA definition and modified Frankel score classification. Paraplegia 32(9):583–587PubMed Capaul M, Zollinger H, Satz N, Dietz V, Lehmann D, Schurch B (1994) Analyses of 94 consecutive spinal cord injury patients using ASIA definition and modified Frankel score classification. Paraplegia 32(9):583–587PubMed
10.
go back to reference Maldague BE, Noel HM, Malghem JJ (1978) The intravertebral vacuum cleft: a sign of ischemic vertebral collapse. Radiology 129(1):23–29CrossRefPubMed Maldague BE, Noel HM, Malghem JJ (1978) The intravertebral vacuum cleft: a sign of ischemic vertebral collapse. Radiology 129(1):23–29CrossRefPubMed
11.
go back to reference Malghem J, Maldague B, Labaisse MA, Dooms G, Duprez T, Devogelaer JP et al (1993) Intravertebral vacuum cleft: changes in content after supine positioning. Radiology 187(2):483–487CrossRefPubMed Malghem J, Maldague B, Labaisse MA, Dooms G, Duprez T, Devogelaer JP et al (1993) Intravertebral vacuum cleft: changes in content after supine positioning. Radiology 187(2):483–487CrossRefPubMed
12.
go back to reference Hatano H, Oike N, Ariizumi T, Sasaki T, Kawashima H (2016) Intravertebral cleft in pathological vertebral collapse resulting from cancer metastasis: report of three cases. Skeletal Radiol 45(12):1747–1750CrossRefPubMed Hatano H, Oike N, Ariizumi T, Sasaki T, Kawashima H (2016) Intravertebral cleft in pathological vertebral collapse resulting from cancer metastasis: report of three cases. Skeletal Radiol 45(12):1747–1750CrossRefPubMed
13.
go back to reference Kawaguchi S, Horigome K, Yajima H, Oda T, Kii Y, Ida K et al (2010) Symptomatic relevance of intravertebral cleft in patients with osteoporotic vertebral fracture. J Neurosurg Spine 13(2):267–275CrossRefPubMed Kawaguchi S, Horigome K, Yajima H, Oda T, Kii Y, Ida K et al (2010) Symptomatic relevance of intravertebral cleft in patients with osteoporotic vertebral fracture. J Neurosurg Spine 13(2):267–275CrossRefPubMed
14.
go back to reference Chen GD, Lu Q, Wang GL, Zou J, Yang HL, Yang Y et al (2015) Percutaneous kyphoplasty for Kummell disease with severe spinal canal stenosis. Pain Physician 18(6):E1021–E1028PubMed Chen GD, Lu Q, Wang GL, Zou J, Yang HL, Yang Y et al (2015) Percutaneous kyphoplasty for Kummell disease with severe spinal canal stenosis. Pain Physician 18(6):E1021–E1028PubMed
16.
go back to reference Kim SB, Jeon TS, Lee WS, Roh JY, Kim JY, Park WK (2010) Comparison of kyphoplasty and lordoplasty in the treatment of osteoporotic vertebral compression fracture. Asian Spine J 4(2):102–108CrossRefPubMedPubMedCentral Kim SB, Jeon TS, Lee WS, Roh JY, Kim JY, Park WK (2010) Comparison of kyphoplasty and lordoplasty in the treatment of osteoporotic vertebral compression fracture. Asian Spine J 4(2):102–108CrossRefPubMedPubMedCentral
17.
go back to reference Huang Y, Peng M, He S, Tang X, Dai M, Tang C (2016) Clinical efficacy of percutaneous kyphoplasty at the hyperextension position for the treatment of osteoporotic Kummell disease. Clin Spine Surg 29(4):161–166PubMed Huang Y, Peng M, He S, Tang X, Dai M, Tang C (2016) Clinical efficacy of percutaneous kyphoplasty at the hyperextension position for the treatment of osteoporotic Kummell disease. Clin Spine Surg 29(4):161–166PubMed
18.
go back to reference Jung JY, Lee MH, Ahn JM (2006) Leakage of polymethylmethacrylate in percutaneous vertebroplasty: comparison of osteoporotic vertebral compression fractures with and without an intravertebral vacuum cleft. J Comput Assist Tomogr 30(3):501–506CrossRefPubMed Jung JY, Lee MH, Ahn JM (2006) Leakage of polymethylmethacrylate in percutaneous vertebroplasty: comparison of osteoporotic vertebral compression fractures with and without an intravertebral vacuum cleft. J Comput Assist Tomogr 30(3):501–506CrossRefPubMed
Metadata
Title
Corpectomy and circumferential fusion for advanced thoracolumbar Kümmell’s disease
Author
Y. Cho
Publication date
01-12-2017
Publisher
Springer Milan
Published in
MUSCULOSKELETAL SURGERY / Issue 3/2017
Print ISSN: 2035-5106
Electronic ISSN: 2035-5114
DOI
https://doi.org/10.1007/s12306-017-0480-1

Other articles of this Issue 3/2017

MUSCULOSKELETAL SURGERY 3/2017 Go to the issue