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Comparison of Scheuermann’s kyphosis correction by combined anterior–posterior fusion versus posterior-only procedure

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Abstract

Introduction

Conventional treatment of rigid deformity in Scheuermann’s kyphosis (SK) in young patients includes a preliminary anterior spinal release and fusion (ASF) followed by posterior spinal fusion and instrumentation (PSF). However, recently there are more trends to do posterior-only surgery for correction of this deformity. The aim of our study was to compare clinical and radiological outcomes of ASF/PSF and PSF-only procedures in treatment of SK.

Materials and methods

In a prospective clinical and radiological review, thirty operated SK patients in two groups were evaluated. Group A: ASF/PSF technique (n: 16) and group B: PSF-only procedure (n: 14) were followed for at least 2 years (average 57.6 months). Two groups were well matched for the following four criteria: average age, flexibility status, posterior fusion levels, and preoperative Cobb’s kyphosis angle. Oswestry disability index (ODI) and scoliosis research society questionnaire-30 (SRS-30) and radiological (kyphosis correction, correction loss, sagittal balance) parameters were evaluated before and after surgery and at the final follow-up.

Results

In group A, primary thoracic Cobb’s kyphosis, immediate post-operative kyphosis, and final follow-up kyphosis angle were 83.6°, 41.4° and 43°, respectively (P < 0.05). Correction rate and correction loss were 50.5 % and 1.6° ± 2.4, respectively. In group B, the corresponding values were 81.9°, 40.1° and 43.2°, respectively (P < 0.05). Correction rate and correction loss were 51 % and 3.1° ± 2.5, respectively. SRS-30 and ODI scores in group A were averaged 68.5 and 21.3 preoperatively and 128.7 and 6.25 at the final follow-up, respectively. In group B, the corresponding values were 64 and 23.2 preoperatively and 133.5 and 5.8 at the final follow-up, respectively.

Conclusions

Clinical and radiological parameters were similar in both groups after surgical correction while, complication rates, operation time and blood loss were significantly higher in ASF/PSF procedure.

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Acknowledgments

We appreciate Dr Majid Rezvani and Dr Mohammadreza Mehrabanian for their radiographic assessment as independent reviewers.

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Authors and Affiliations

  1. Department of Orthopedic Spinal Surgery, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

    Mohammadreza Etemadifar, Alireza Ebrahimzadeh & Abdollah Hadi

  2. Department of Orthopedic, Isfahan University of Medical Sciences, Isfahan, Iran

    Mehran Feizi

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  1. Mohammadreza Etemadifar
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  2. Alireza Ebrahimzadeh
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  3. Abdollah Hadi
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  4. Mehran Feizi
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Correspondence to Abdollah Hadi.

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Etemadifar, M., Ebrahimzadeh, A., Hadi, A. et al. Comparison of Scheuermann’s kyphosis correction by combined anterior–posterior fusion versus posterior-only procedure. Eur Spine J 25, 2580–2586 (2016). https://doi.org/10.1007/s00586-015-4234-1

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  • DOI: https://doi.org/10.1007/s00586-015-4234-1

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