Spontaneous fusion across the apex of severe thoracolumbar Scheuermann's kyphosis: A surgical consideration.

Considerable debate exists regarding the pathogenesis, natural history and treatment of Scheuermann's kyphosis. Surgical correction is indicated in the presence of severe kyphosis which carries the risk of neurological complications, persistent back pain and significant cosmetic deformity. This can be achieved through a posterior-only or an anteroposterior approach. Spontaneous fusion in association with Scheuermann's kyphosis has not been previously described. This is an important consideration if surgical correction of the kyphosis is planned. Two patients with severe thoracolumbar Scheuermann's kyphosis who developed spontaneous posterior and anteroposterior fusion across the apex of the deformity are presented. The surgical treatment and final outcome is discussed.