Double L-rod instrumentation in the treatment of severe kyphosis secondary to Scheuermann's disease.

Patients with untreated kyphosis secondary to Scheuermann's disease occasionally develop significant deformities associated with pain in adult life. When these painful deformities do not respond to conservative measures, surgery may be indicated. This report describes a two-stage surgical technique for correction of the deformity. First, an anterior spinal release and fusion is performed and is followed 7-10 days later by a posterior spinal fusion with double L-rod instrumentation. L-rod instrumentation has the advantage that no postoperative immobilization is necessary, which allows the patient to return to a relatively normal life-style in the immediate postoperative period. Excellent maintenance of correction of the deformity in these patients has occurred with no serious complication to date in 24 patients followed from 19 months to 4 years although "transient hyperesthesia" occurred in 16% of patients. A longer follow-up will be necessary to evaluate fully possible late pseudarthrosis and instrumentation failure in this group of patients.