SURGICAL CORRECTION OF SCHEUERMANN’S KYPHOSIS IN CHILDREN

Abstract

Objective. To present specific surgical technique for juvenile kyphosis correction and analyze results of surgical treatment for spinal deformity in children with Scheuermann’s disease using transpedicular spinal instrumentation systems. Material and Methods. The study included ten patients aged 14 to 17 years with kyphotic spinal deformity associated with Scheuermann’s disease. The mean deformity magnitude was 73.1° (range, 60° to 90°). Kyphosis apex was located at the T7 (n = 5), T8 (n = 1), T9 (n = 3), or T10 (n = 1) level. Surgical intervention was performed through combined approach using disc-apophysis-ectomy and fusion at the apex of kyphosis, and placement of multiple anchor spinal instrumentation. Results. Five patients received the hybrid instrumentation, and other five – transpedicular one. Surgical treatment resulted in reduction of kyphosis to 32.1° with average deformity correction of 41°. Average number of fixed vertebrae in patients with hybrid instrumentation was 14, and in those with total transpedicular fixation – 13. The loss of correction in the long-term follow-up was observed in patients with hybrid multiple anchor instrumentation. Conclusion. The use of pedicle screws as anchors in surgical treatment of juvenile kyphosis in children with Scheuermann’s disease allows for effective deformity correction, restoration of physiological profiles of the spine, elimination of postoperative curve progression, shortening of instrumentation length, prevention of junctional kyphosis development, and maintaining of the achieved results.