title: Osteoporotic vertebral fractures and collapse with intravertebral vacuum sign (Kümmel's disease).
abstract: The intravertebral vacuum phenomenon was first described by Kümmel and is also known as delayed vertebral collapse or vertebral pseudarthrosis. Clinically, it occurs in approximately 10% of vertebral osteoporotic fractures, mainly in the thoracolumbar zone, is accentuated on extension views and associated with benign fractures. Most patients are neurologically intact, and continued pain is a common symptom that responds well to stabilization. Various theories exist in the literature about the pathogenesis; data support a combination of ischemia and psuedarthrosis. The ultimate treatment plan must be individualized and involve decompression of neurologic elements--when present--and sufficient stabilization, which varies according to surgeon preference and the patient's combordities.
authors.affiliation: Department of Orthopedic Surgery, University of Kentucky, Lexington, Kentucky, USA.
authors.forename: Ioannis P
authors.initials: IP
authors.lastname: Pappou
authors.forename: Elias C
authors.initials: EC
authors.lastname: Papadopoulos
authors.forename: Andrew N
authors.initials: AN
authors.lastname: Swanson
authors.forename: Frank P
authors.initials: FP
authors.lastname: Cammisa
authors.forename: Federico P
authors.initials: FP
authors.lastname: Girardi
mesh_terms: D050815:Fractures, Compression / Q000150:complications*; D006801:Humans; D008279:Magnetic Resonance Imaging; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D019637:Orthopedic Procedures; D010024:Osteoporosis / Q000150:complications*; D016103:Spinal Fractures / Q000150:complications*; D016896:Treatment Outcome; D014618:Vacuum