Guillaume Riouallon1, Christian Morin2, Yann-Philippe Charles3, Pierre Roussouly4, Gaby Kreichati5, Ibrahim Obeid6, Stéphane Wolff7. 1. Groupe Hospitalier Paris Saint-Joseph, 185, rue Raymond Losserand, 75014, Paris, France. griouallon@hpsj.fr. 2. Hopale/Institut Calot, Berck/Mer, France. 3. Service de Chirurgie Orthopédique du Rachis et de Traumatologie du Sport, Hôpital Civil, Pavillon Chirurgical B, 1, place de l'Hôpital, 67091, Strasbourg Cedex, France. 4. Des Massues Surgical Center, 92, rue Edmond-Locard, 69322, Lyon, France. 5. Hôpital Hôtel-Dieu de France, Université Saint-Joseph, Beyrouth, Lebanon. 6. Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France. 7. Groupe Hospitalier Paris Saint-Joseph, 185, rue Raymond Losserand, 75014, Paris, France.
Abstract
PURPOSE: The literature shows controversies concerning surgical treatment of Scheuermann's kyphosis between posterior-only fixation and combined anterior/posterior fusion. The aim of this study is to compare the clinical and radiological results and the rate of complications between these two techniques. METHODS: We performed a multicentric retrospective review of 131 patients who underwent primary fusion for Scheuermann's kyphosis divided into two groups: 67 patients operated via posterior approach only and 64 operated via combined anterior/posterior approach. Classical clinical, surgical and radiological data were collected. A descriptive and statistical analysis was performed between the two groups to evaluate the influence of the surgical procedure on the rate of complications, the functional results and radiological correction. RESULTS: The average age was 23 and the average kyphosis was 77 degrees. The mean follow-up was 4.2 years (range 0.1-27.3). There was no difference regarding demographic data, preoperative radiographic data and length of fusion between the two groups. Functional results were good in 81% of cases. Kyphosis correction was on average 15° and the correction of the compensatory lumbar lordosis was 20°. The correction was stable at final follow-up. There was no difference between the two groups in terms of functional results, the complications rate and radiological correction. CONCLUSION: Surgery for Scheuermann's kyphosis gives good and stable functional and radiological results. Given the fact that the two surgical strategies give the same results, it appears that the anterior/posterior fusion technique to treat Scheuermann's kyphosis should be reserved for major deformations. These slides can be retrieved under Electronic Supplementary Material.
PURPOSE: The literature shows controversies concerning surgical treatment of Scheuermann's kyphosis between posterior-only fixation and combined anterior/posterior fusion. The aim of this study is to compare the clinical and radiological results and the rate of complications between these two techniques. METHODS: We performed a multicentric retrospective review of 131 patients who underwent primary fusion for Scheuermann's kyphosis divided into two groups: 67 patients operated via posterior approach only and 64 operated via combined anterior/posterior approach. Classical clinical, surgical and radiological data were collected. A descriptive and statistical analysis was performed between the two groups to evaluate the influence of the surgical procedure on the rate of complications, the functional results and radiological correction. RESULTS: The average age was 23 and the average kyphosis was 77 degrees. The mean follow-up was 4.2 years (range 0.1-27.3). There was no difference regarding demographic data, preoperative radiographic data and length of fusion between the two groups. Functional results were good in 81% of cases. Kyphosis correction was on average 15° and the correction of the compensatory lumbar lordosis was 20°. The correction was stable at final follow-up. There was no difference between the two groups in terms of functional results, the complications rate and radiological correction. CONCLUSION: Surgery for Scheuermann's kyphosis gives good and stable functional and radiological results. Given the fact that the two surgical strategies give the same results, it appears that the anterior/posterior fusion technique to treat Scheuermann's kyphosis should be reserved for major deformations. These slides can be retrieved under Electronic Supplementary Material.
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