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

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 degrees (65 degrees-80 degrees) preoperatively and 41 degrees (31 degrees-52 degrees) postoperatively. There was a mean loss of correction of 5 degrees. No positive sagittal balance was present during follow-up. The mean TKA in post-trauma cases was 38 degrees (25 degrees-62 degrees) pre-operatively and 14 degrees (range -15 degrees-28 degrees) postoperatively. At the last visit, the mean loss of correction was 2 degrees. Proximal junctional kyphosis developed in two cases with Scheuermann kyphosis (17 degrees and 13 degrees) and in one case with post-traumatic kyphosis (17 degrees). 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.