Diaremes Panagiotis, Braun Sebastian, Meurer Andrea
Klinik für Orthopädie (Friedrichsheim), Universitätsklinikum Frankfurt, Marienburgstr. 2, 60528, Frankfurt am Main, Deutschland.
Orthopade. 2022 Apr;51(4):339-348. doi: 10.1007/s00132-022-04239-4. Epub 2022 Mar 15.
Scheuermann's disease represents the second most common deformity of the growing spine after the various forms of scoliosis. In cases of early diagnosis and mild kyphotic deformity conservative treatment with a brace and physiotherapy shows very good results; however, in cases of neurologic deficits, curve progression despite conservative treatment and increasing pain symptoms with a Stagnara angle of more than 70-75°, surgical treatment is meaningful. The surgical strategy can include posterior spondylodesis with prior anterior release or posterior instrumentation with posterior column osteotomy depending on the surgeon's experience. The choice of the extent of the operation with the vertebrae to be instrumented and including the straightening method should be oriented to the avoidance of complications, such as proximal or distal junctional kyphosis.
休曼氏病是继各种形式的脊柱侧弯之后,生长中的脊柱第二常见的畸形。在早期诊断且驼背畸形较轻的病例中,使用支具和物理治疗的保守治疗效果非常好;然而,在出现神经功能缺损、尽管进行了保守治疗但侧弯仍进展以及疼痛症状加重且施塔尼亚拉角超过70 - 75°的情况下,手术治疗是有意义的。手术策略可包括根据外科医生的经验,先行前路松解后行后路脊柱融合术,或行后路器械固定并后路椎体截骨术。手术范围的选择,即确定要进行器械固定的椎体以及包括矫直方法,应以避免并发症(如近端或远端交界性后凸)为导向。