Scheuermann disease presenting as compressive myelopathy.

A 17-year-old boy had progressive stiffness of lower limbs and decreased pain and touch sensation on the right, then left, leg for 1 month. He had mild kyphosis, grade IV spasticity, pyramidal pattern of weakness in lower limbs, brisk reflexes, and extensor plantar responses with impaired spinothalamic and posterior column sensation below T7. Imaging suggested Scheuermann disease (figure), which manifests in adolescence as rigid kyphosis with wedging of at least 5° of each of 3 adjacent vertebrae (Sorensen criteria).1 Thoracolumbar Scheuermann disease is type I, which is progressive; if symptomatic, surgical treatment is indicated. Type II or lumbar type is not progressive.2