Background Data:

Kümmel’s Disease is defined as osteonecrosis of the vertebrae, which is characterized radiologically by the phenomenon of vacuum clefts within the vertebral corpus.

Purpose:

To evaluate the pain relief and quality of life on treatment of Kümmel’s Disease with vertebroplasty.

Materials and Methods:

Between 2005 and 2010, 14 patients with Kümmel’s Disease received a percutaneous vertebroplasty procedure in our department. The mean follow-up was 32 months. The inclusion criteria were: 1. prolonged pain symptoms for more than three months, 2. the presence of a vacuum phenomenon in direct X-rays or CAT scans, and 3. related findings in fat-suppressed T2 magnetic resonance imaging. The VAS, Oswestry Disability Index, and radiographic parameters, including the sagittal index, local kyphosis angle, and compression rate, were compared preoperatively and postoperatively.

Results and Conclusion:

The VAS and Oswestry scores were significantly improved in all of the patients (p<0.05). There were no significant differences between the preoperative and postoperative radiographic measurements (p>0.05). There was cement leakage to the paravertebral space in one patient, which remained asymptomatic. The characteristic radiological finding of Kümmel’s Disease has been shown in previous studies to be the phenomenon of vacuum clefts. The cause of pain is pathological dynamic mobility of the unfused fracture. Filling the cleft with bone cement can relieve the pain by reducing the dynamic mobility.

Keywords: Kümmel Disease, vertebral osteonecrosis, osteoporotic vertebral fracture, vertebroplasty