Results of surgical treatment for kyphotic deformity of the spine secondary to trauma or Scheuermann's disease

Abstract

The authors have performed a retrospective study of 20 patients who underwent surgical treatment for kyphosis secondary to trauma (10 patients) or Scheuermann's disease (10 patients) between 1992 and 2000. The mean follow-up was 60 months (range, 32-90) and 59.5 months (range, 24-109) respectively. Radiological evaluation of Scheuermann kyphosis included assessment of thoracic kyphosis angle (TKA), lumbar lordosis angle (LLA), scoliosis angle (SA) and sagittal vertical axis (SVA); radiological evaluation of post-traumatic kyphosis included the determination of local kyphosis angle (LKA) and SA, if present. A posterior approach was performed in 6 cases and a combined anterior and posterior approach was performed in 4 cases of SD whereas patients with post-trauma kyphosis were treated using an anterior approach in one case, a posterior approach in another and a combined anterior and posterior approach in 8 cases . The mean TKA in Scheuermann cases was 71° (65°-80°) preoperatively and 41° (31°-52°) postoperatively. There was a mean loss of correction of 5°. No positive sagittal balance was present during follow-up. The mean TKA in post-trauma cases was 38° (25°-62°) pre-operatively and 14° (range -15°-28°) postoperatively. At the last visit, the mean loss of correction was 2°. Proximal junctional kyphosis developed in two cases with Scheuermann kyphosis (17° and 13°) and in one case with post-traumatic kyphosis (17°). These findings show that good results can be achieved in the treatment of kyphosis secondary to trauma or Scheurmann's disease, with appropriate selection of the surgical approach.