[Spastic paraparesis in Scheuermann disease: a case report]

Area of Science:

• Spine Surgery
• Neurology
• Orthopedics

Background:

• ScheuAermann's disease is a condition causing kyphosis, typically in adolescents.
• Spastic paraparesis, a neurological condition affecting leg movement, can have various causes.
• Spinal cord compression is a potential complication of severe spinal deformities.

Observation:

• A 17.5-year-old male presented with paraparesis and moderate dorsal kyphosis (64 degrees) due to Scheuermann's disease.
• Intraspinal lipoma was suspected radiologically, but ruled out during surgery.
• Surgical intervention involved ventral release, anterior spondylodesis, and dorsal spondylodesis with Harrington instrumentation.

Findings:

• Postoperatively, the patient showed complete resolution of neurological deficits.
• Radiographic evaluation three months after surgery revealed a solid spondylodesis with a corrected Cobb angle of 38 degrees.
• The likely pathophysiological mechanism involved direct or indirect spinal cord compression at the apex of the kyphosis.

Implications:

• This case highlights the effectiveness of surgical intervention in managing paraparesis secondary to Scheuermann's disease.
• Aggressive surgical correction can improve neurological function and spinal alignment in severe kyphosis.
• Understanding the pathophysiology is crucial for timely diagnosis and treatment of spinal cord compromise in these patients.