Surgical Strategies and Challenges in Scheuermann's Kyphosis: A Comprehensive Review

Area of Science:

• Orthopedics
• Spinal Surgery
• Medical Review

Background:

• Scheuermann's kyphosis (SK) involves significant vertebral wedging, causing pain and deformity.
• Current surgical treatments for SK lack a consensus on the optimal approach.
• Identifying the best surgical management for SK is crucial.

Purpose of the Study:

• To review surgical indications for Scheuermann's kyphosis.
• To describe current instrumentation methods and techniques for SK correction.
• To identify ideal surgical management and associated complications.

Main Methods:

• Comprehensive literature review of PubMed, Web of Science, and Google Scholar (last 20 years).
• Inclusion of peer-reviewed original studies detailing SK interventions and clinical outcomes.
• Analysis of 30 studies meeting inclusion criteria.

Main Results:

• Common indications include intractable pain, failed conservative treatment, deformity progression, and neurological issues.
• Surgical approaches include anterior (AO), posterior-only (PO), and combined anterior-posterior (AP).
• Common complications: hardware failure, loss of correction, Proximal Junctional Kyphosis; PO fusion showed reduced blood loss and operative duration.

Conclusions:

• Published studies show conflicting results on SK treatment effectiveness.
• Posterior-only (PO) fusion is associated with a lower complication rate.
• PO fusion's reduced complications are driving its increased popularity in SK treatment.