Abstract
OBJECTIVE: To describe the results of surgical treatment of Scheuermann's disease by the posterior approach. METHOD: A descriptive, retrospective, longitudinal study in which patients with Scheuermann's disease, treated surgically by the posterior approach at the Hospital de Traumatologia y Ortopedia [Hospital for Traumatology and Orthopedics] "Lomas Verdes" IMSS. The Cobb method was used to measure the kyphosis in all the patients, of T5-T12. The surgical technique used was vertebral shortening by the Ponte osteotomy technique, at the apex of the deformity, accompanied by transpedicular instrumentation and posterior arthrodesis. RESULTS: Five patients were included; three men and two women, with an average age of 16.6 years. The initial average kyphosis was 76º, which was corrected to 42º after surgery. Blood loss was 590 ml, with a surgery time of 3 hours. Three patients were submitted to neurophysiological monitoring. No neurological lesion was found. There was no loss of correction at 6 months of evolution. CONCLUSIONS: The vertebral shortening technique with posterior instrumentation eliminates the use of the anterior approach to release the anterior longitudinal ligament. Osteotomies by the Ponte technique make the spine more flexible, and together with pedicular instrumentation, correct the deformity and preserve the correction over time.
Highlights
Scheuermann’s disease, known as juvenile kyphosis, is a structural vertebral deformity that causes hyperkyphosis at the thoracolumbar level, due to the development of vertebral wedging during adolescence.[1]
The normal range of thoracic kyphosis varies, the Scoliosis Research Society defines the normal range as 10-40 degrees of kyphosis between T5 and T12.3
In type 1 juvenile kyphosis, the apex is usually between T1 and T8, and there are three or more vertebrae wedged more than 5 degrees
Summary
Scheuermann’s disease, known as juvenile kyphosis, is a structural vertebral deformity that causes hyperkyphosis at the thoracolumbar level, due to the development of vertebral wedging during adolescence.[1] It occurs in 0.4 to 0.8% of the population. The normal range of thoracic kyphosis varies, the Scoliosis Research Society defines the normal range as 10-40 degrees of kyphosis between T5 and T12.3. Wenger[4] describes two types of juvenile kyphosis: the classic thoracic form, type 1, and the atypical thoracolumbar form, type 2. In type 1 juvenile kyphosis, the apex is usually between T1 and T8, and there are three or more vertebrae wedged more than 5 degrees. Type 2 thoracolumbar form has more irregularities, such as a decrease in the intervertebral spaces and anterior Schmorl’s nodes.[5]
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