Sagittal Plane Alignment and Functional Outcomes Following Surgery for Scheuermann Kyphosis

Area of Science:

• Orthopedics
• Spine Surgery
• Biomechanical Analysis

Background:

• Scheuermann hyperkyphosis (SK) is a spinal deformity requiring surgical intervention.
• Pelvic parameters and sagittal balance significantly influence spinal alignment and surgical outcomes.
• Understanding the correlation between pelvic parameters, sagittal balance, and functional results in SK is crucial for optimizing surgical treatment.

Purpose of the Study:

• To evaluate and correlate pelvic parameters, sagittal balance (SB), and functional outcomes in patients undergoing surgical treatment for Scheuermann hyperkyphosis (SK).
• To assess the impact of surgical correction on thoracic kyphosis (TK) and lumbar lordosis (LL).
• To identify risk factors for complications, particularly proximal junctional kyphosis (PJK).

Main Methods:

• Retrospective review of 19 patients who underwent surgery for SK between 2005 and 2016.
• Radiographic measurements included TK, LL, SB, pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS).
• Complications and functional outcomes (SRS-22 scores) were recorded and analyzed.

Main Results:

• Surgical correction significantly reduced mean TK from 83° to 57° and improved LL.
• Postoperative SB remained neutral, with no significant influence on functional outcomes or LL.
• A high pelvic incidence (PI) was associated with a greater rate of PJK complications.

Conclusions:

• Surgical correction of SK leads to spontaneous improvement in lumbar hyperlordosis.
• Postoperative functional results are generally high but not statistically correlated with TK or LL.
• Pelvic parameters, especially high PI, are critical considerations for managing PJK risk during SK surgical treatment.