Kummell's disease is a rare, delayed posttraumatic collapse of a vertebral body 
that can occur several months or even years after an osteoporotic compression 
fracture. However, there are few reports of posterior element fractures 
associated with Kummell's disease. A 72-year-old man who had sustained an L1 
osteoporotic compression fracture 14 months prior was admitted to our 
institution with incapacitating back pain. Plain radiographs showed progressive 
collapse of the L1 vertebral body and severe kyphosis at the thoracolumbar 
junction. Magnetic resonance imaging revealed a posterior element fracture as 
well as osteonecrosis of the L1 vertebral body. An L1 percutaneous 
vertebroplasty was performed, followed by bone cement-augmented screw fixation 
to maintain stability and correct the kyphotic deformity. After surgery, pain 
relief was immediate, and the patient was able to walk unassisted. This case 
illustrates that continuous axial distraction stress caused by aggravated 
kyphosis secondary to Kummell's disease may result in posterior element 
fractures. Our discussion concludes with a literature review.