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A Look Back at the Results of Surgery for Scheuermann's Kyphosis

Posted on: 11/28/2007
In this study, surgeons take a look back and review the results of 78 patients who had surgery for Scheuermann's kyphosis. The results of this study provide updated outcomes using current implant systems and surgical techniques.

Scheuermann's kyphosis is an excessive forward curve of the thoracic spine. The thoracic spine refers to the mid-spine between the neck and the lumbar (lower) spine. Viewed from the side, the thoracic spine is normally curved like the letter C. The opening of the C faces the front of the body.

With Scheuermann's kyphosis, too much curvature gives the person a hunchback appearance. Bracing is often used to help control the progression of this condition. But surgery may be needed if the curve gets worse despite conservative care.

The authors were interested in finding out how two different surgical methods compared. The first approach fused the spine from the front and back of the vertebrae. This was called a combined anterior-posterior arthrodesis. The second method fused the spine just from the back of the spine. This procedure is called a posterior arthrodesis.

They also measured loss of correction and junctional kyphosis. Junctional kyphosis refers to the formation of increased kyphosis above or below the fusion. The goal was to find risk factors that might contribute to these complications. Patients were followed for up to six years.

The results showed that complications were much more common in the group that had the combined anterior-posterior fusion. Loss of correction was more likely in patients having just the posterior fusion.

Junctional kyphosis occurred in up to one-third of the patients. This appeared to be linked with the angle of the pelvis. It was not the result of using a particular type of anchor (hook or screw) to fuse the spine.

Overall, the authors recommend the posterior arthrodesis over the combined anterior-posterior approach. More study is needed to find ways to prevent junctional kyphosis and other complications that require additional surgery.

Baron S. Lonner, MD et al. Operative Management of Scheuermann's Kyphosis in 78 Patients. In Spine. November 15, 2007. Vol. 32. No. 24. Pp. 2644-2652.

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