[Scheuermann's Hyperkyphosis - Posterior-Only Surgical Approach Using the Smith-Petersen Osteotomies]

PURPOSE OF THE STUDY Evaluation of efficiency and safety in surgically treated patients with Scheuermann hyperkyphosis using posterior-only surgical approach. MATERIAL AND METHODS Our study retrospectively evaluates the results of surgical correction in group of 20 patients with Scheuermann's hyperkyphosis, with an average age of 13 years and 8 month and with follow-up 4 years and 5 month. We evaluated changes of thoracic kyphosis as well as lumbar lordosis in correlation with surgical correction. Furthermore we compared ability of kyphosis to be corrected while performing reclination X-rays befroe surgery in comparation with rate of surgical correction. RESULTS The average correction of thoracic kyphosis was 52% - from preoperative 92° to postoperative 44°. We observed of 36% improvement of correction while surgically corrected in comparision with preoperative recklination X-ray pictures. Secondary correction of lumbar lordosis was from preoperative 84° to posoperative 55°. DISCUSSION Conservative treatment of hyperkyphosis offers only limited treatment results. Combined surgical approach with anterior release and posterior stabilization increase risk of anterior approach and secondary decreasing of lung capacity. Posterior vertberal osteotomies allows quality release and preparation for consecutive correction. Transpedicular instrumentation makes possible segmental correction of kyphotic spine using compression method. CONCLUSIONS Posterior-only surgical approach in combination with vertebral osteotomies allow efective and safe correction of hyperkyhosis in Scheuermann disease. Key words: Scheuermann, hyperkyphosis, transpedicular screws, osteotomy, posterior approach.