INTRODUCTION

Scheuermann’s kyphosis is a structural deformity of the spine that affects roughly 2.2% of the global population ranging from 0.4 to 10% [1, 2]. Scheuermann’s kyphosis results in progressive thoracic and/or thoracolumbar hyperkyphosis in the spinal structure; consequently, ends in severe back pain in the afflicted population [3]. The structural deformity root in osteonecrosis of vertebral apophyses resulting in wedging of at least three adjacent vertebrae [1]. Another theory for the pathophysiology of this disease is alterations in endochondral ossification [4].

Patients with Scheuermann’s kyphosis are classified into typical and atypical. Typical cases have thoracic spine involvement, while atypical Scheuermann’s kyphosis cases have wedging in lumbar or thoracolumbar regions [5, 6]. The management of atypical cases initiate with conservative treatments such as bracing and analgesics, but for thoracolumbar curves greater than 25 to 30 degrees, surgical interventions are indicated, whereas the cutoff value for surgical interventions in thoracic Scheuermann’s kyphosis is curvatures greater than 70 to 75 degrees [7]. However, surgical treatment of atypical Scheuermann’s kyphosis is associated with multiple adverse effects, most importantly, junctional kyphosis [8]. It has been shown that spinal sagittal balance does not change significantly after surgical interventions, and is not correlated with preoperative thoracolumbar kyphosis [9, 10]. In this article, we present a case of atypical Scheuermann’s kyphosis who underwent surgical intervention with anterior release and posterior fusion with a 2-year follow-up and excellent outcome without any complications or adjacent segment disease.