title: Pathogenesis of the intravertebral vacuum of Kümmell's disease.
abstract: In this review, we explored the progress of the pathogenesis of Kümmell's disease intravertebral vacuum. Using different expressions of the same disease including 'Kümmell's disease', 'avascular necrosis after vertebral compression fracture (VCF)', 'post-traumatic vertebral osteonecrosis', 'vertebral pseudarthrosis', 'intravertebral vacuum (cleft or gas)', 'delayed vertebral collapse', 'VCF nonunion', and by conducting a search of the PubMed database, we analyzed the results to examine the pathogenesis of the intravertebral vacuum of Kümmell's disease after referring to pertinent literature on intravertebral vacuum of ischemic necrosis after VCF, and exploring the progress of pathogenesis of this disease. A number of discrepancies were identified within the pathogenesis of the intravertebral vacuum after VCF. There were statements such as avascular necrosis of the vertebral body, bone biomechanics, gas forming and other types of claims, all of which obtained clinical and biomechanical supporting evidence. Collectively, most of the researchers believe that Kümmell vertebral fracture syndrome was the comprehensive effect of multiple factors including osteoporosis, avascular necrosis of the vertebral body, and biomechanical changes following fracture. However, there are a number of discrepancies to be resolved and future studies are therefore needed.
authors.affiliation: Department of Orthopaedics, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China; Department of Orthopedics, Lishui Central Hospital, Wenzhou Medical University, Lishui, Zhejiang 323000, P.R. China.
authors.forename: Dengwei
authors.initials: D
authors.lastname: He
authors.affiliation: Department of Orthopedics, Lishui Central Hospital, Wenzhou Medical University, Lishui, Zhejiang 323000, P.R. China.
authors.forename: Weiyang
authors.initials: W
authors.lastname: Yu
authors.affiliation: Department of Orthopedics, Lishui Central Hospital, Wenzhou Medical University, Lishui, Zhejiang 323000, P.R. China.
authors.forename: Zhenzhong
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Orthopedics, Lishui Central Hospital, Wenzhou Medical University, Lishui, Zhejiang 323000, P.R. China.
authors.forename: Liangchen
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Orthopedics, Lishui Central Hospital, Wenzhou Medical University, Lishui, Zhejiang 323000, P.R. China.
authors.forename: Kejun
authors.initials: K
authors.lastname: Zhu
authors.affiliation: Department of Orthopaedics, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China.
authors.forename: Shunwu
authors.initials: S
authors.lastname: Fan
keywords: Kümmell's disease; compression fractures; intravertebral vacuum; osteoporotic vertebral vertebral body; pathogenesis