Spine Surgery pp 203-210 | Cite as

Scheuermann Kyphosis and Ankylosing Spondylitis

  • Mohammad Arabmotlagh
  • Michael Rauschmann


Scheuermann disease is the most common cause of thoracic kyphosis in adolescent, based on the anterior vertebral wedging that develops during the adolescent growth spurt. Physical appearance in adolescence and backpain in adulthood are commonly the reasons for medical consultation. The benign natural history of scheuermann kyphosis necessitates an individualized decision making for treatment options. Surgical treatment is currently performed with multilevel Ponte-osteotomies and modern pedicle screw instrumentation that enables posterior-only correction of the deformity. A proper determination of fusion level is crucial to achieve good result and to avoid adjacent level complications.

Ankylosing spondylitis is a chronic inflammatory disease of joints with pain and progressive stiffness mainly in the spine along with increasing kyphotic deformity leading to the loss of horizontal gaze and difficulty in ambulation. The rigid deformity of the spine along with reduced bone mineral density are challenges facing the surgeon during operative treatment that require a thorough preoperative clinical and radiological evaluation not only of spine but also of the hip and knee joints. Several surgical techniques are available to correct the deformity. Each of them has advantages and limitations that should be weighed out in the process of surgical decision making.


  1. 1.
    Murray PM, Weinstein SL, Spratt KF. The natural history and long-term follow-up of scheuermann kyphosis. J Bone Joint Surg Am. 1993;75(2):236–48.CrossRefGoogle Scholar
  2. 2.
    Ristolainen L, Kettunen JA, Heliövaara M, Kujala UM, Heinonen A, Schlenzka D. Untreated scheuermann’s disease: a 37-year follow-up study. Eur Spine J. 2012;21:819–24.CrossRefGoogle Scholar
  3. 3.
    Lonner BS, Newton P, Betz R, Scharf C, O’Brien M, Sponseller P, Lenke L, Crawford A, Lowe T, Letko L, Harms J, Shufflebarger H. Operative management of scheuermann’s kyphosis in 78 patients. Spine. 2007;32(24):2644–52.CrossRefGoogle Scholar
  4. 4.
    Cho KJ, Lenke LG, Bridwell KH, Kamiya M, Sides B. Selektion of the optimal distal fusion level in posterior instrumentation and fusion for thoracic hyperkyphosis. The sagital stable vertebra concept. Spine. 2009;34(8):765–70.CrossRefGoogle Scholar
  5. 5.
    Roussouly P, Gollogly S, Berthonnaud E, Dimmet J. Classification of the normal variation in the sagittal alignment of the human lumbar spine and pelvis in the standing position. Spine. 2005;30(3):346–53.CrossRefGoogle Scholar
  6. 6.
    Bridwell KH. Decision making regarding Smith-Petersen vs. pedicle substraction osteotomy vs. vertebral column resection for spinal deformity. Spine. 2006;31(19):S171–8.CrossRefGoogle Scholar
  7. 7.
    Kim KT, Park KJ, Lee JH. Osteotomy of the spine to correct the spinal deformity. Asian Spine J. 2009;3(2):113–23.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Mohammad Arabmotlagh
    • 1
  • Michael Rauschmann
    • 2
  1. 1.Spine Department, Academic University Hospital Sana Klinik Offenbach, Goethe University FrankfurtOffenbachGermany
  2. 2.Department of Spine SurgerySana Klinikum OffenbachOffenbachGermany

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