Failed percutaneous kyphoplasty in treatment of stage 3 Kummell disease: A case report and literature review

RATIONALE: Albeit it is rare, the authors report a stage 3 Kummell disease case. It is diagnosed by dynamic thoracic magnetic resonance imaging (MRI). Because there is no established strategy on stage 3 Kummell disease, we performed percutaneous kyphoplasty at first, but unfortunately made a revisio...

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Autores principales: Zhang, Chenggui, Wang, Guodong, Liu, Xiaoyang, Li, Yang, Sun, Jianmin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709019/
https://www.ncbi.nlm.nih.gov/pubmed/29382020
http://dx.doi.org/10.1097/MD.0000000000008895
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author Zhang, Chenggui
Wang, Guodong
Liu, Xiaoyang
Li, Yang
Sun, Jianmin
author_facet Zhang, Chenggui
Wang, Guodong
Liu, Xiaoyang
Li, Yang
Sun, Jianmin
author_sort Zhang, Chenggui
collection PubMed
description RATIONALE: Albeit it is rare, the authors report a stage 3 Kummell disease case. It is diagnosed by dynamic thoracic magnetic resonance imaging (MRI). Because there is no established strategy on stage 3 Kummell disease, we performed percutaneous kyphoplasty at first, but unfortunately made a revision surgery to remove the polymethylmethacrylate (PMMA) cement after the failure of percutaneous kyphoplasty. PATIENT CONCERNS: A 73-year-old lady with severe back pain due to osteoporosis vertebral fracture was admitted to our hospital on June 23, 2016. She underwent percutaneous kyphoplasty with the back pain improved shortly. Unfortunately, she went back to our hospital due to aggravated back pain and partial paralysis on July 25, 2016. DIAGNOSES: Kummell disease, lumbar stenosis, lacunar infarction. OUTCOMES: Specially, the compression of spinal cord was obvious in the hyperflexion position on dynamic MRI. Even though there was no improvement in muscle strength, the patient was satisfied with the back pain relief after percutaneous kyphoplasty. But, the same back pain reappeared after about 1 month. Then, we took out the PMMA cement and performed posterior vertebral column resection. At last, the back pain was relieved again but the muscle strength was improved not obviously after operation. At the same time, the kyphosis was corrected and the intravertebral stability was achieved. LESSONS: Dynamic MRI is helpful in Kummell disease with neurologic symptoms, even if there is no obvious compression in the neutral position. Furthermore, the intravertebral instability is probably the main reason of the neurologic symptoms in this case. Percutaneous kyphoplasty could not reconstruct the intravertebral stability. Stage 3 Kummell disease with obvious intravertebral instability should be treated by open surgery.
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spelling pubmed-57090192017-12-07 Failed percutaneous kyphoplasty in treatment of stage 3 Kummell disease: A case report and literature review Zhang, Chenggui Wang, Guodong Liu, Xiaoyang Li, Yang Sun, Jianmin Medicine (Baltimore) 3700 RATIONALE: Albeit it is rare, the authors report a stage 3 Kummell disease case. It is diagnosed by dynamic thoracic magnetic resonance imaging (MRI). Because there is no established strategy on stage 3 Kummell disease, we performed percutaneous kyphoplasty at first, but unfortunately made a revision surgery to remove the polymethylmethacrylate (PMMA) cement after the failure of percutaneous kyphoplasty. PATIENT CONCERNS: A 73-year-old lady with severe back pain due to osteoporosis vertebral fracture was admitted to our hospital on June 23, 2016. She underwent percutaneous kyphoplasty with the back pain improved shortly. Unfortunately, she went back to our hospital due to aggravated back pain and partial paralysis on July 25, 2016. DIAGNOSES: Kummell disease, lumbar stenosis, lacunar infarction. OUTCOMES: Specially, the compression of spinal cord was obvious in the hyperflexion position on dynamic MRI. Even though there was no improvement in muscle strength, the patient was satisfied with the back pain relief after percutaneous kyphoplasty. But, the same back pain reappeared after about 1 month. Then, we took out the PMMA cement and performed posterior vertebral column resection. At last, the back pain was relieved again but the muscle strength was improved not obviously after operation. At the same time, the kyphosis was corrected and the intravertebral stability was achieved. LESSONS: Dynamic MRI is helpful in Kummell disease with neurologic symptoms, even if there is no obvious compression in the neutral position. Furthermore, the intravertebral instability is probably the main reason of the neurologic symptoms in this case. Percutaneous kyphoplasty could not reconstruct the intravertebral stability. Stage 3 Kummell disease with obvious intravertebral instability should be treated by open surgery. Wolters Kluwer Health 2017-11-27 /pmc/articles/PMC5709019/ /pubmed/29382020 http://dx.doi.org/10.1097/MD.0000000000008895 Text en Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by-nd/4.0 This is an open access article distributed under the Creative Commons Attribution-NoDerivatives License 4.0, which allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author. http://creativecommons.org/licenses/by-nd/4.0
spellingShingle 3700
Zhang, Chenggui
Wang, Guodong
Liu, Xiaoyang
Li, Yang
Sun, Jianmin
Failed percutaneous kyphoplasty in treatment of stage 3 Kummell disease: A case report and literature review
title Failed percutaneous kyphoplasty in treatment of stage 3 Kummell disease: A case report and literature review
title_full Failed percutaneous kyphoplasty in treatment of stage 3 Kummell disease: A case report and literature review
title_fullStr Failed percutaneous kyphoplasty in treatment of stage 3 Kummell disease: A case report and literature review
title_full_unstemmed Failed percutaneous kyphoplasty in treatment of stage 3 Kummell disease: A case report and literature review
title_short Failed percutaneous kyphoplasty in treatment of stage 3 Kummell disease: A case report and literature review
title_sort failed percutaneous kyphoplasty in treatment of stage 3 kummell disease: a case report and literature review
topic 3700
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709019/
https://www.ncbi.nlm.nih.gov/pubmed/29382020
http://dx.doi.org/10.1097/MD.0000000000008895
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