Twenty-one patients with
Scheuermann's kyphosis had surgery for progressive kyphotic
deformity of 50 degrees or greater. There were six adolescents, with a mean age of 15.6 years (range, 13-17 years) and 15 young adults, with a mean age of 25.4 years (range, 18-40 years). All patients had posterior spine
arthrodesis with segmental compression instrumentation. Seven patients with rigid
kyphosis had combined anterior and posterior spine
arthrodesis. One patient died of
superior mesenteric artery syndrome. In the group of 13 patients with posterior
arthrodesis only, followup was 4.5 years. The mean preoperative thoracic kyphotic curve of 68.5 degrees improved to 40 degrees at latest review, with an average loss of correction of 5.75 degrees. Junctional
kyphosis occurred in two patients with a short
arthrodesis: one at the cephalad end and one at the caudal end of the fused kyphotic curve. In the second group of seven patients with combined anterior and posterior
arthrodesis, followup was 6 years. The mean preoperative thoracic kyphotic curve of 86.3 degrees improved to 46.4 degrees at latest review, with an average loss of correction of 4.4 degrees. Overall, there was no postoperative
neurologic deficit and no
pseudarthrosis. Thus, posterior
arthrodesis and segmental compression instrumentation seems to be effective for correcting and stabilizing kyphotic
deformity in
Scheuermann's disease. Despite a long operating time, this technique provided significant correction, avoiding the development of any secondary
deformity in most patients. Combined anterior and posterior spine
arthrodesis is recommended for rigid, more severe kyphotic
deformities.