Treatment of kyphotic deformity in Kümmell’s disease through vertebral body screw fixation and intertransverse process grafting: A case report

Author:

Kang Hui1,Wei Tanjun1,Zeng Wenbo2,Lan Shenghui13ORCID

Affiliation:

1. Department of Orthopaedics, General Hospital of Central Theater Command (Wuhan General Hospital of Guangzhou Command, previously), Wuhan, China

2. Department of Orthopaedics, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China

3. Department of Orthopaedics, The Eighth People’s Hospital, Jiangsu University, Shanghai, China.

Abstract

Rationale: Kümmell’s disease, also well acknowledged as delayed posttraumatic vertebral body collapse, it is a rare condition which mainly occurs in elderly people more than 50 years old, with the thoracolumbar junction being mostly affected. Patient concerns: In this research, we employed posterior short-segment screw fixation within the injured vertebral region, coupled with intertransverse process bone grafting, to address Kümmell’s disease. A 57-year-old female was admitted to our institution with incapacitating back pain and obvious kyphotic deformity. Diagnoses: The diagnosis of Kummell disease was mainly depended on clinical symptoms and imaging examinations. Interventions: In this research, we employed posterior short-segment screw fixation within the injured vertebral region, coupled with intertransverse process bone grafting, to address Kümmell’s disease. Outcomes: The patient could walk independently with the help of a thoracolumbosacral orthosis brace on postoperative Day 2. No pains, kyphotic deformity and neurological deficits were observed during the 36 months of postoperative follow-up. These improvements can be visualized through postoperative magnetic resonance imaging and CT scans. Short-segment screw fixation provides short-term stability to the fracture site and accelerates fracture healing. Subsequently, the healed intervertebral and transverse process grafts offer long-term stability, a fact corroborated by postoperative CT scans. Lessons: In summary, for Kümmell’s disease patients exhibiting kyphotic deformity without neurological deficits or compression, posterior short-segment vertebral screw fixation with intertransverse process bone grafting stands as a viable alternative treatment approach.

Publisher

Ovid Technologies (Wolters Kluwer Health)

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