Thoracic Cord Compression in Scheuermannʼs Disease

Yablon, Jeffrey S.; Kasdon, David L.; Levine, Harvey L.

doi:10.1097/00007632-198808000-00004

Cited by 49 publications

(7 citation statements)

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“…The anterior approach is also indicated in patients with Scheuermann's disease to correct both the kyphotic deformity and the disc herniation. We used this strategy in our series in a patient with Scheuermann's disease 35,36. Because a corpectomy is performed with this procedure, a fusion is needed followed by an extended period of bracing and bed rest.…”

Section: Discussionmentioning

confidence: 99%

Surgical approaches to thoracic disc herniations

et al. 1991

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Early diagnosis of thoracic disc herniations has become more common with the advent of spinal magnetic resonance imaging (MRI). This early diagnosis combined with choosing the optimal surgical approach, to ensure adequate decompression without excessive cord and root manipulation, will achieve the optimum results. It is now clear that more lateral and anterior approaches to the thoracic spine are required to achieve this goal. We report our experience in the operative management of 21 patients with thoracic disc herniation using three different surgical approaches: transpedicular-transfacetal, posterolateral-extrapleural (costotransversectomy) and transthoracic-transpleural. The clinical and radiologic findings and results in all of our cases are reviewed as are the technique of and indication for each of the three surgical approaches.

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Section: Discussionmentioning

confidence: 99%

Surgical approaches to thoracic disc herniations

et al. 1991

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“…[1415] Although back pain in adult patients with Scheuermann's kyphosis is often secondary to spondylosis associated with deformity, untreated Scheuermann's kyphosis reveals higher risk of back pain than controls nearly fourfold. [131617]…”

Section: Discussionmentioning

confidence: 99%

Successful brace treatment of Scheuermann's kyphosis with different angles

Etemadifar

Jamalaldini

layeghi

2017

J Craniovert Jun Spine

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Background:Scheuermann's disease is regarded as the most common cause of structural hyperkyphosis within adolescents without any proper treatment. It may lead to progressive deformity and back pain which influences patient's quality of life during adolescence and adulthood. Treatment approach to Scheuermann's kyphosis has not been clearly defined due to its different definitions and obscure natural history. The goal of treatment is not only to prevent progression but also to obtain permanent correction. Bracing, especially Milwaukee brace and physiotherapy are two of the common nonoperative treatment modalities. Hence, the present study intended to evaluate the effectiveness of Milwaukee brace on progression control as well as correction of Scheuermann's kyphosis.Materials and Methods:In a retrospective, observational study, all the patients diagnosed with Scheuermann's kyphosis were reviewed in 2003–2013, who were treated by Milwaukee brace at a single center. There was a minimum of 2-year follow-up after completion of bracing, during which clinical and radiological parameters were identified and recorded.Results:The mean angle of kyphosis in these patients at the presentation was 63.24 ± 9.96 and at the end of this study was 36.5° ± 13.4° (P < 0.001). Moreover, mean improved angle in those patients with <75° of kyphosis was 25.26° ± 7.78° and in those with 75° or more than 75° of kyphosis was 26.77° ± 19.76° (P < 0.001).Conclusion:Conservative treatment with Milwaukee brace and physiotherapy was effective in our hand for halting kyphosis progression in 97.5% of Scheuermann's kyphosis, which could be advised for cases up to 90° of kyphosis before skeletal maturity. As a result, a trial of brace treatment could be recommended in patients with severe kyphosis (up to 90°) which can open a new insight in conservative treatment of Scheuermann's kyphosis.

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“…There have been several reports of paraparesis secondary to disc disorders in Scheuermann disease. 2,5,6 Direct anterior decompression and fusion have been recommended to treat these lesions. Whether further stabilization is required depends in large part on the magnitude of the kyphosis and the age of the patient.…”

Section: Discussionmentioning

confidence: 99%

“…LTHOUGH several cases of progressive myelopathy resulting from congenital kyphosis, 1,2 Scheuermann dorsal kyphosis, [3][4][5] or Cushing disease 6 have been reported, myelopathy caused by thoracic kyphosis in elderly patients seems to be more rare. To our knowledge there are no other reports in the English-language literature of symptomatic progressive thoracic kyphosis in this patient population.…”

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confidence: 99%

Flexion myelopathy of the thoracic spine

Fujibayashi

Neo

Nakamura

2007

SPI

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✓The authors report a rare case of surgically treated symptomatic thoracic kyphosis caused by dynamic compression in an elderly man. Myelopathy due to thoracic kyphosis has been reported in patients with congenital kyphosis, Scheuermann dorsal kyphosis, and Cushing disease, but to the authors’ knowledge this is the first report of dynamic kyphosis in an elderly person. This otherwise healthy 84-year-old man presented with a 2-year history of progressive difficulty in walking and bilateral leg dysesthesia. Despite several cervical and lumbar surgeries, his symptoms gradually worsened. A radiological examination revealed severe thoracic kyphosis, with a lateral Cobb angle of 59° from T-2 to T-12. On a dynamic computed tomography (CT) myelogram, severe thoracic spinal cord draping and stretching on flexion was demonstrated. On extension, however, imaging studies failed to show draping or stretching. Posterior corrective fusion was performed with instrumentation from T-2 to T-9. Postoperative CT myelography demonstrated no significant spinal cord compression with restoration of the cerebrospinal fluid space anterior to the spinal cord, and the successful correction of the kyphosis to 44°. The patient’s neurological sequelae gradually resolved throughout 6 months of follow up.

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Thoracic Cord Compression in Scheuermannʼs Disease

Cited by 49 publications

References 0 publications

Surgical approaches to thoracic disc herniations

Surgical approaches to thoracic disc herniations

Successful brace treatment of Scheuermann's kyphosis with different angles

Flexion myelopathy of the thoracic spine

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