Severe rigid Scheuermann kyphosis in adult patients; correction with posterior-only approach

Purpose: Scheuermann kyphosis is the most common structural kyphosis among adolescence and young people. Surgical treatment may be performed through combined anterior and posterior or posterior-only approaches; to our knowledge, the efficacy of posterior-only approach as less invasive procedure is not well studied in case of severe rigid Scheuermann kyphosis. Materials and methods: Eighteen patients with severe rigid Scheuermann kyphosis operated through only posterior approach from 2013 to 2016 were evaluated. All information regarding demographic data, curve size before and after the surgery, surgical time, amount of blood loss, correction loss during follow-up and also complications was collected. Result: There were six females and 12 males. Mean age of the patients was 22.4 years (range 17–38). Mean kyphosis angle before surgery was 87.2° (range 85–105), and that reduced to 47.4° (range 45–55) after the surgery. Mean curve size in hyperextension view was 73.8°. Mean postoperative Cobb angle was 50–55 percent of preoperative curves. Mean hospital admission duration was 3.5 days after the index surgery (range 3–5 days). Mean blood loss during the surgery was 250 ml. Mean surgical duration time was 150 min. Mean follow-up period was 9 months (range 8–48 months). No complication was found among the patients. Conclusion: Posterior-only approach using advanced osteotomy techniques and posterior release is a safe and reliable approach for treatment of patients suffering from severe rigid Scheuermann kyphosis and provides acceptable deformity correction. © 2017, Istituto Ortopedico Rizzoli.