Failed Percutaneous Vertebroplasty Due to Insufficient Correction of Intravertebral Instability in Kummell's Disease: A Case Report

Jung Eun Kim, Sang Sik Choi, Mi Kyoung Lee, Dong Kyu Lee, Seung Inn Cho

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Kummell's disease, caused by osteonecrosis of the vertebral body, is a cause of vertebral collapse. In Kummell's disease, intravertebral instability from nonunion between the cement and bone after percutaneous vertebroplasty (PVP) can cause persistent severe pain and dysfunction. A 75-year-old woman presented with severe pain in the lower back, both buttocks, groin, and both posterior thighs for a period of 30 days. Lumbar radiographs and magnetic resonance images showed an acute compression fracture of the first lumbar vertebra with an intravertebral cleft filled with fluid. The patient underwent PVP for the L1 compression fracture; however, this failed to provide sufficient pain relief. The patient was re-evaluated with dynamic radiography, and intravertebral instability and bone cement displacement of the L1 vertebra were detected. Repeat PVP was performed. After the procedure, intravertebral instability was restored and her pain completely subsided. PVP is a good treatment choice for symptomatic Kummell's disease. However, there is no consensus on the best technique of injecting bone cement to achieve optimal results. It is important to inject more bone cement than the volume of the intravertebral cleft to prevent instability caused by nonunion in PVP for Kummell's disease. We report a case of failed PVP because of insufficient correction of intravertebral instability in Kummell's, along with a review of the literature.

Original languageEnglish
Pages (from-to)1109-1114
Number of pages6
JournalPain Practice
Volume17
Issue number8
DOIs
Publication statusPublished - 2017 Nov 1

Fingerprint

Vertebroplasty
Bone Cements
Compression Fractures
Pain
Lumbar Vertebrae
Buttocks
Osteonecrosis
Groin
Low Back Pain
Thigh
Radiography
Consensus
Spine
Magnetic Resonance Spectroscopy

Keywords

  • intravertebral instability
  • intravertebral vacuum cleft
  • Kummell's disease
  • nonunion
  • percutaneous vertebroplasty
  • vertebral compression fracture

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Failed Percutaneous Vertebroplasty Due to Insufficient Correction of Intravertebral Instability in Kummell's Disease : A Case Report. / Kim, Jung Eun; Choi, Sang Sik; Lee, Mi Kyoung; Lee, Dong Kyu; Cho, Seung Inn.

In: Pain Practice, Vol. 17, No. 8, 01.11.2017, p. 1109-1114.

Research output: Contribution to journalArticle

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