Scheuermann's kyphosis

Scheuermannova bolest najčešći je uzrok adolescentne kifoze. Incidencija iznosi između 1% i 8%. Češće se pojavljuje u muškaraca. Razlikujemo dva oblika po položaju deformiteta: tipični oblik (torakalna kifoza) i atipični oblik (torakolumbalna ili lumbalna kifoza). Etiologija je i dalje nejasna ali najzastupljenija teorija je ona koja govori o genetskoj podlozi bolesti. Bolesnici imaju veću učestalost bolova u donjem dijelu leđa i bave se lakšim fizičkim poslovima. U dijagnostici bolesti potrebno je uzeti detaljnu anamnezu, napraviti klinički pregled te snimiti standardne radiološke snimke. Za postavljanje dijagnoze potrebno je na snimkama uočiti karakteristična anteriorna uklinjenja tijela najmanje 3 susjedna kralješka za ≥5°. Liječenje kifoze može biti konzervativno i kirurško. Fizikalnom terapijom i ortozama se može utjecati na smanjenje kifoze prije koštane zrelosti. Kirurško liječenje rezervirano je za kifoze >80° u torakalnoj ili >65° u torakolumbalnoj kralježnici. Postoje razni kirurški pristupi, a posteriorni pristup je zlatni standard u kirurškom liječenju. U posteriornom pristupu moguće je koristiti jednu od dvije tehnike: kompresijsku ili tehniku poluge. Najčešće komplikacije operacijskog liječenja su gubitak korekcije, kifoza proksimalnog ili distalnog spoja te infekcija.Scheuermann's kyphosis is the most frequent cause of adolescent kyphosis. Its reported incidence ranges from 1% to 8%. The prevalence is higher in males. According to the position of the deformity, two types are known: type I (thoracic kyphosis) and type II (thoracolumbar or lumbar kyphosis). The etiology of the disease is still unknown but the genetic proclivity seems to be the most plausible theory. Studies have shown that patients complain of lower back pain and are employed in physically less demanding jobs. In order to establish the accurate diagnosis it is important to review medical history, examine the patient and take standard radiographs. The finding of three adjacent anteriorly wedged vertebral bodies for ≥5° is diagnostic. The treatment of kyphosis is mainly non-operative. Rehabilitation and orthotic devices are used to slow down or correct the deformity before skeletal maturity. Surgery is mainly performed in the cases when kyphosis is greater than 80° in the thoracic and 65° in the lumbar spine. Although there are multiple surgical approaches, the posterior one represents a golden standard. There are two techniques that can be used in the posterior approach: compression and cantilever technique. The most common surgical complications are the loss of correction, junctional kyphosis (proximal and/or distal) and infection