Scheuermann kyphosis: Safe and effective surgical treatment using multisegmental instrumentation

Study Design. A retrospective review was conducted on 23 consecutive patients who underwent surgical correction of Scheuermann kyphosis using modern multisegmental instrumentation. Objective. To evaluate Scheuermann kyphosis correction and complication rates. Summary of Background Data. The surgical treatment of Scheuermann kyphosis remains a topic of debate. The literature of the 70s and 80s on the surgical management of this disorder using Harrington instrumentation demonstrated that operative correction is quite effective but associated with significant complications. This literature, however, may be less applicable to current clinical situations. The use of modern multisegmental instrumentation and increased awareness of potential complications may decrease the risks of current operative treatment. Methods. Hospital charts, office charts, and radiographs on 23 consecutive patients who underwent operative treatment using multisegmental instrumentation for Scheuermann kyphosis were reviewed to identify complications of surgery. Complications were classified as minor, major, or life threatening. Results. The mean follow-up was 38 months ( range 10-123 months). Preoperative kyphosis ranged from 63 to 104degrees with an average of 83degrees. Twenty of the 23 patients (87%) underwent combined anterior release/arthrodesis with posterior arthrodesis/multisegmental instrumentation. The remaining 3 patients underwent posterior arthrodesis/multisegmental instrumentation. Postoperative total kyphosis ranged from 32 to 67 with an average of 46degrees. At final follow-up, the total kyphosis ranged from 37 to 75 with an average of 51degrees. Overall, we had 43% minor complications, 17% major complications, and 0% life-threatening complications. Conclusions. Surgical correction of Scheuermann kyphosis can be performed safely and effectively using modern multisegmental instrumentation.