Kümmell disease

Last revised by Ciro Menna Barreto Duarte on 25 Nov 2023

Kümmell disease is an eponymous name for osteonecrosis and collapse of a vertebral body.

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  • osteoporosis

  • corticosteroid use

  • alcoholism

  • radiation therapy

Kümmell disease represents delayed (usually two weeks) vertebral body collapse due to ischemia and non-union of anterior vertebral body wedge fractures after minor trauma.

  • shows collapse of affected vertebrae (typically lower thoracic and upper lumbar)

  • an intravertebral vacuum cleft and fluid may be seen (accentuated on extension stress lateral views), although this is non-specific

  • the intravertebral vacuum cleft is usually seen as low signal intensity with all sequences

  • if intravertebral fluid is present it is low T1 signal and high T2 signal

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

This condition was first described by the German surgeon Hermann Kümmell (1852-1937) in 1891 4,8.

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