Case Report
Spinal Cord (2009) 47, 570–572; doi:10.1038/sc.2008.133; published online 11 November 2008
Progressive spastic paraplegia: the combination of Scheuermann's disease, a short-segmented kyphosis and dysplastic thoracic spinous processes
C Putz1, I Stierle1, T Grieser2, G Mohr1, H J Gerner1, C H Fürstenberg1 and B Wiedenhöfer1
- 1Department of Spine Surgery and Spinal Cord Injury Center, Orthopaedic University Hospital Heidelberg, Heidelberg, Germany
- 2Department of Radiology, Orthopaedic University Hospital Heidelberg, Heidelberg, Germany
Correspondence: Dr C Putz, Orthopaedic University Hospital Heidelberg, Schlierbacher Landstrasse 200a, Baden-Württemberg, Heidelberg D-69118, Germany. E-mail: cornelia.putz@ok.uni-heidelberg.de
Received 6 May 2008; Revised 8 September 2008; Accepted 4 October 2008; Published online 11 November 2008.
Abstract
Study design:
Case report.
Objective:
To describe a rare case of paraplegia in a patient with Scheuermann's disease and dysplastic thoracic spinous processes.
Setting:
Spinal Cord Injury Center, Orthopaedic University Hospital Heidelberg, Heidelberg, Germany.
Clinical presentation:
The authors report on a 15-year-old boy with progressive incomplete spastic paraplegia presenting segmental dysplastic thoracic spinous processes and Scheuermann's disease. The magnetic resonance imaging showed a kyphotic angulation at T 5/6 and signs of myelopathy. Hypoplastic thoracic processes and hypoplastic paraspinal muscles in the upper thoracic spine were observed intraoperatively. In this case, dorsoventral stabilization from T 4–7 was performed and the neurological outcome improved at follow-up (6 months).
Conclusion:
Paraplegia can be accelerated in patients with Scheuermann's disease, severe kyphotic angulation and dysplastic posterior elements. After operative treatment, neurological recovery and a normal walking pattern were shown.
Keywords:
Scheuermann's disease, spastic paraplegia, kyphosis, dysplastic spinous processes, thoracic spine
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