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A Novel Surgical Indication for Scheuermann’s Kyphosis – Lumbar Fusion

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The article discusses the surgical treatment of Scheuermann kyphosis to restore proper sagittal alignment, particularly in cases where thoracic curves exceed 70°. Patients who have reached their limit of compensatory lumbar hyperlordosis are at risk of degeneration, which can be assessed through radiographic comparisons. The article presents a case study of an adolescent boy with Scheuermann kyphosis who underwent a successful T4 to L2 posterior spinal fusion with Ponte Smith-Petersen grade two osteotomies. The patient tolerated the procedure well and progressed to normal activity at the 5-month follow-up. Overall, the study highlights the importance of surgical intervention in cases where conservative management is no longer effective in addressing the condition

Summarised by Mr Mo Akmal – Lead Spinal Surgeon
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Published article

Scheuermann kyphosis can be treated surgically to restore proper sagittal alignment. Thoracic curves >70° are typically indicated for surgical intervention. However, patients who have reached their natural limit of compensatory lumbar hyperlordosis are at risk of accelerated degeneration. This can be determined by comparing lumbar lordosis on standing neutral radiographs and supine extension radiographs. Minimal additional lordosis in extension compared with neutral, abutment of the spinous…

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J Am Acad Orthop Surg Glob Res Rev. 2024 Mar 5;8(3). doi: 10.5435/JAAOSGlobal-D-23-00187. eCollection 2024 Mar 1.ABSTRACTScheuermann kyphosis can be treated surgically to restore proper sagittal alignment. Thoracic curves >70° are typically indicated for surgical intervention. However, patients who have reached their natural limit of compensatory lumbar hyperlordosis are at risk of accelerated degeneration. This,

J Am Acad Orthop Surg Glob Res Rev. 2024 Mar 5;8(3). doi: 10.5435/JAAOSGlobal-D-23-00187. eCollection 2024 Mar 1.

ABSTRACT

Scheuermann kyphosis can be treated surgically to restore proper sagittal alignment. Thoracic curves >70° are typically indicated for surgical intervention. However, patients who have reached their natural limit of compensatory lumbar hyperlordosis are at risk of accelerated degeneration. This can be determined by comparing lumbar lordosis on standing neutral radiographs and supine extension radiographs. Minimal additional lordosis in extension compared with neutral, abutment of the spinous processes, or greater lumbar lordosis standing than with attempted extension suggest the patient is maximally compensated. We present a case of an adolescent boy with Scheuermann kyphosis who had reached the limit of his hyperlordosis compensation reserve. He subsequently underwent a T4 to L2 posterior spinal fusion with T7 to T11 Ponte Smith-Petersen grade two osteotomies. He tolerated the procedure well with no intraoperative complications or neuromonitoring changes. The patient has continued to do well and progressed to normal activity at 5-month follow-up.

PMID:38441155 | DOI:10.5435/JAAOSGlobal-D-23-00187

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A Novel Surgical Indication for Scheuermann’s Kyphosis

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J Am Acad Orthop Surg Glob Res Rev. 2024 Mar 5;8(3). doi: 10.5435/JAAOSGlobal-D-23-00187. eCollection 2024 Mar 1.ABSTRACTScheuermann kyphosis can be treated surgically to restore proper sagittal alignment. Thoracic curves >70° are typically indicated for surgical intervention. However, patients who have reached their natural limit of compensatory lumbar hyperlordosis are at risk of accelerated degeneration. This

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