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Scheuermann's kyphosis: surgical management.

Vincent Arlet1, Dietrich Schlenzka

  • 1Department of Orthopaedic Surgery, University of Virginia, Charlottesville, VA 22908, USA. Va3e@hscmail.mcc.virginia.edu

European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
|April 15, 2005
PubMed
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Surgery for Scheuermann disease is rare, with indications including severe curves (>75 degrees) or pain, especially in adults. While posterior fusion is advancing, anterior release remains crucial for rigid curves, with long-term outcomes of newer techniques still under investigation.

Area of Science:

  • Orthopedics
  • Spine Surgery
  • Adolescent Deformity

Background:

  • Scheuermann disease indications for surgery are poorly defined.
  • The natural history is typically benign, with conservative treatment for moderate curves in adolescents.
  • Surgery is considered for severe curves or persistent pain, particularly in adults.

Purpose of the Study:

  • To review current surgical indications and techniques for Scheuermann disease.
  • To discuss the role of anterior release versus posterior fusion.
  • To highlight considerations for modern spinal instrumentation and long-term outcomes.

Main Methods:

  • Review of surgical indications for Scheuermann disease.
  • Discussion of anterior release (conventional, mini-open, VAST) and posterior fusion techniques.

Related Experiment Videos

  • Analysis of instrumentation strategies and potential complications.

    • Main Results:

    • Surgery is indicated for cosmetic reasons (curves >75 degrees) or pain, especially in adults.
    • Third-generation posterior instrumentation is powerful, but long-term results are unknown.
    • Anterior release is still necessary for very rigid and large curves.
    • Proper posterior instrumentation requires fusing the entire Cobb angle, stopping above the first lordotic disc to prevent sagittal decompensation.

    Conclusions:

    • Careful consideration is needed regarding posterior-only instrumentation due to potential loss of correction or pseudarthrosis.
    • Anterior release remains vital for severe, rigid Scheuermann kyphosis.
    • Newer techniques like short anterior fusion and pedicle subtraction osteotomies are experimental for this condition.