Our results of surgical treatment with posterior instrumentation of patients with scheuermann kyphosis

Aim; To evaluate the recovery and complication rates in patients with Scheuermann's kyphosis treated with pedicle screws without involving the apical vertebra with a posterior segmental approach. Summary; Surgical treatment is recommended for adolescents with progressive kyphosis above 70 degrees, progressing despite breys therapy, back pain and cosmetic deformity. Surgical options are posterior spinal arthrodesis with or without anterior spinal release. In recent years, fusion with only posterior instrumentation and posterolateral bone graft is one of the most popular surgical treatment options for Scheuermann's kyphosis. Material method; Between 2005 and 2019 (mean follow-up 98 months), 20 (mean age 17.5) patients with Scheuermann's kyphosis were treated with a single-stage posterior pedicle instrumentation combined with posterior bone grafting. Cobb angle changes, sagittal and coronal balance parameters, SF-36 and SRS-22r scores and complications were evaluated. Results; All patients had pre-op, early and late post-op follow-up AP and lateral ortorontgenograms. Mean pre-op thoracic kyphosis angle is 75 degrees, lumbar lordosis is 46 degrees, sagittal balance is -20 mm. Early post-op mean thoracic kyphosis angle was 38 degrees (p<0,05), lombar lordosis was 33 degrees (p<0,05), sagittal balance -19 mm. Proksimal and distal junctional kyphosis of 10 degrees or greater was seen in 7 and 2 patients, respectively. Both proksimal and distal junction kyphosis were seen in 1 patient. The mean SRS-22r score was calculated as 3.9 (lowest 2.7-maximum 4.6). Revision surgery was performed in 1 patient due to the pull-out of 2 proximal screws. No infection or neurological complication was observed. Conclusion; The pedicle screw use technique allows posterior correction of the deformity without the need for anterior loosening. We achieved acceptable correction with posterior segmental instrumentation where the apical vertebra was not screwed. This technique is a useful method in the treatment of Scheuermann's kyphosis. Keywords; Scheuermann kyphosis, Posterior spinal surgery, pedicle screw.