RESULTS OF SURGICAL TREATMENT OF SCHEUERMANN’S KYPHOSIS USING SEGMENTAL INSTRUMENTATION
https://doi.org/10.14531/ss2011.4.27-34
Abstract
Objective. To analyze results of surgical treatment of Scheuermann’s kyphosis using segmental instrumentation.
Material and Methods. Sixty eight operated patients were divided into two groups. Patients from Group 1 underwent only posterior procedure in skeletal traction, and patients from Group 2 - anterior and posterior procedures. In 18 (26.4 %) cases, patients were treated using segmental vertebrotomy and formation of compression anchor at the apex of deformity. The caudal anchor of instrumentation using transpedicular screws was formed in 10 (14.7 %) patients.
Results. Kyphosis decreased from 76.2° ± 11.3° to 42.4° ± 10.4° in Group 1, and from 80.1° ± 11.5° to 39.5° ± 12.2° in Group 2; the loss of correction at 1 year after surgery was 7.9° ± 4.4° in Group 1, and 2.9° ± 5.8° in Group 2. The use of transpedicular fixation reduces the length of instrumentation by one segment.
Conclusion. Two-stage surgical treatment including skeletal traction from calvarial bones to supramalleolar area, discectomy and interbody fusion with bone autograft at the apex, and correction of spinal deformity with segmental instrumentation, is the most effective treatment technique for severe progressive kyphosis in Scheuermann’s disease.
About the Authors
Mikhail Vitalyevich MikhailovskyRussian Federation
Artyom Nikilayevich Sorokin
Russian Federation
Vyacheslav Vladimirovich Novikov
Russian Federation
Aleksandr Sergeyevich Vasyura
Russian Federation
Maya Nikolayevna Lebedeva
Russian Federation
Elena Vladimirovna Gubina
Russian Federation
References
1. Ветрилэ С.Т., Кулешов А.А., Швец В.В. и др. Оперативное лечение тяжелых деформаций позвоночника // Вестн. Российской академии медицинских наук. 2008. № 8. С. 34–40.
2. Заявка № 2010115936 Российская Федерация. Способ коррекции ригидного кифоза Шейерманна / Новиков В.В., Васюра А.С., Михайловский М.В. и др.; приоритет 21.04.2010.
3. Михайловский М.В., Новиков В.В., Васюра А.С.и др. Коррекция кифозов на почве болезни Шейерманна // Хирургия позвоночника. 2005. № 2. С. 50–55.
4. Михайловский М.В., Фомичев Н.Г. Хирургия деформаций позвоночника. Новосибирск, 2002.
5. Райе Р.Э. Коррекция деформаций позвоночника с помощью инструментария Cotrel – Dubousset // Проблемы хирургии позвоночника и спинного мозга: Тез. докл. Всерос. науч.-практ. конф. Новосибирск, 1996.
6. Ali RM, Green DW, Patel TC. Scheuermann’s kyphosis. Curr Opin Pediatr. 1999;11(1):70–75.
7. Arlet V, Schlenzka D. Scheuermann’s kyphosis: surgical management. Eur Spine J. 2005;14(9):817–827.
8. Burton DC. Smith-Petersen osteotomy of the spine. Instr Course Lect. 2006;55:577–582.
9. Cho KJ, Bridwell KH, Lenke LG, et al. Comparison of Smith-Petersen versus pedicle subtraction osteotomy for the correction of fixed sagittal imbalance. Spine. 2005;30(18):2030–2037.
10. Geck MJ, Macagno A, Ponte A, et al. The Ponte procedure: posterior only treatment of Scheuermann’s kyphosis using segmental posterior shortening and pedicle screw instrumentation. J Spinal Disord Tech. 2007;20(8):586–593.
11. Grevitt M, Kamath V, Avadhani A, et al. Correction of thoracic kyphosis with Ponte osteotomy. Eur Spine J. 2010;19(2):351–352.
12. Holt RT, Dopf CA, Isaza JE, et al. Adult kyphosis. In: Frymoyer JW, ed. The Adult Spine. Principles and Practice. 2nd ed. Philadelphia, 1997:1537–1578.
13. Koptan WM, Elmiligui YH, Elsebaie HB. All pedicle screw instrumentation for Scheuermann’s kyphosis correction: is it worth it? Spine J. 2009;9(4):296–302.
14. Papagelopoulos PJ, Mavrogenis AF, Savvidou OD, et al. Current concepts in Scheuermann’s kyphosis. Orthopedics. 2008;31(1):52–58.
15. Scheuermann HW. Kyphosis dorsalis juvenilis. Ugeskr Laeger. 1920;82:385–393.
16. Wenger D, Frick S. Scheuermann kyphosis. Spine. 1999;24(24):2630–2369.
Review
For citations:
Mikhailovsky M.V., Sorokin A.N., Novikov V.V., Vasyura A.S., Lebedeva M.N., Gubina E.V. RESULTS OF SURGICAL TREATMENT OF SCHEUERMANN’S KYPHOSIS USING SEGMENTAL INSTRUMENTATION. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2011;(4):027-034. (In Russ.) https://doi.org/10.14531/ss2011.4.27-34