Scheuermann Kyphosis and Ankylosing Spondylitis
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.