Wedge-Compression Fractures

FACTS

 

HPI

 

PHYSICAL EXAM

IMAGING

 
A/P

Kummell Disease

  • delayed (weeks - months) post-traumatic vertebral collapse representing avascular osteonecrosis, occurs due to traumatic blood supply compromise → avascular necrosis
  • clinically the presentation is: mild back pain from the compression fractures → feels better as heals → osteonecrosis produces significant pain
  • imaging: intravertebral vacuum cleft sign = gas-filled cleft
  • management: conservative (bracing, pain control), kyphoplasty or instruementation in severe collapse/progressive kyphosis
Figure 1: Octegenarian male with a L1 compression fracture with < 25% VHL managed conservatively re-presented one month later with Kummel disease.
Figure 1: Octegenarian male with a L1 compression fracture with < 25% VHL managed conservatively re-presented one month later with Kummel disease.