Kummell's Disease Treated with Conservative Management - A case report -

Kummell's disease is a rare disorder defined as delayed avascular necrosis of a vertebral body after minor trauma. Diagnosis is based on clinical presentation of delayed onset back pain and kyphosis after minor trauma, and on intravertebral vacuum cleft in radiologic examination. Verte-broplasty or surgical management is necessary to the patients with risks of vertebral collapse or cord compromise, but we experienced a successful result after active conservative management to a patient with severe vertebral collapse and mild spinal cord compression without myelopathy. A 76-year old woman had back pain and gait disturbance 7 weeks after fall down. X-ray and MRI showed a vacuum cleft in T12 vertebra. We treated her conservatively with bed rest and immobilization followed by gradual weight bearing with thoracic-lumbar-sacral orthosis. Back pain and gait disturbance was improved after conservative management, and the improvement was maintained until 8 months after fall down.