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.