Surgical correction of Scheuermann's kyphosis by posterior-only approach: a prospective study

Background: The authors aimed to evaluate the clinical and radiographic results of the posterior-only approach in the treatment of Scheuermann's kyphosis using pedicle screws with Ponte osteotomies. Methods: Twenty-one consecutive patients with Scheuermann's kyphosis within the operative range were included in this prospective study. Patients were operated by a posterior-only approach using pedicle screws. Multiple Ponte osteotomies were performed at and around the apex. Mean operative time, blood loss, and any complications related to the procedure were reported. Patients were assessed radiographically by measuring thoracic kyphosis angle, lumbar lordosis angle, sagittal balance, and the Voutsinas index of kyphosis. Patients were assessed clinically using the Scoliosis Research Society questionnaire (SRS-22). Results: There were 18 male patients and 3 female patients with a mean age of 21 yr. The mean blood loss was 847.6 cc. The mean operative time was 196.9 min. The mean follow-up period was 36 mo. The mean preoperative thoracic kyphosis was 78.1 +/- 5.8 degrees, which improved to 41.9 +/- 3.7 degrees postoperatively. At the final follow-up, the mean thoracic kyphosis was 42.3 +/- 3.8 degrees. The mean lumbar lordosis was 71.1 +/- 3.4 degrees preoperatively, 51.6 +/- 1.7 degrees postoperatively, and 53.4 +/- 3.7 degrees at the final follow-up. The mean Voutsinas index of kyphosis was 19.6 +/- 7.6 preoperatively, which became 13.4 +/- 4.8 early postoperatively and 13.5 +/- 3.6 at the final follow-up. The SRS 22 questionnaire improved significantly from a mean of 2.7 +/- 1.3 preoperatively to 4.3 +/- 2.2 at the final follow-up. Conclusions: The posterior-only approach is a successful technique in treatment of Scheuermann's kyphosis.