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Kummel disease

Dr Tim Luijkx and Radswiki et al.

Kummel disease is an eponymous name for avascular necrosis of the vertebrae.

Pathology

Kummel disease represents delayed (usually two weeks) vertebral body collapse due to ischaemia and non-union of the anterior vertebral body wedge fractures after major trauma.

Risk factors

Risk factors include:

  • osteoporosis
  • corticosteroid use
  • alcoholism
  • radiation therapy

Radiographic features

Plain film/CT
  • shows collapse of affected vertebrae
  • an intravertebral vacuum cleft and fluid may be seen (accentuated on extension stress lateral views), although this is non-specifc
MRI
  • the intravertebral vacuum cleft is usually seen as low signal intensity with all sequences
  • if intravertebral fluid is present it is low T1 signal on and high T2 signal

The severity of the vertebral collapse has been found to be higher in those who have intravertebral gas compared to only intravertebral fluid, signifying that the presence intra-vertebral air is possibly a more advance stage of the disease 1

History and etymology

This condition was first described by Herman Kummell in 1891 4.

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