Abstract | STUDY DESIGN: Retrospective. OBJECTIVES: SUMMARY OF BACKGROUND DATA: The initial treatment of choice of Scheuermann's kyphosis is thoracic hyperextension and postural exercises and/or Milwaukee brace. Milwaukee bracing is most efficacious in the early stages when the curvature is flexible and in the skeletally immature. However, it is known that larger curves, vertebral wedging greater than 10 degrees, and skeletally mature patients will not usually respond to this treatment. Surgery is indicated in the skeletally immature with severe deformity where brace treatment has failed to prevent progression. Posterior spinal instrumentation can achieve adequate correction in the less rigid curves. However, the more rigid curves have been shown to be resistant to posterior spinal fusion alone, therefore needing anterior spinal release. METHODS: Between 1995 and 2001, 19 patients underwent video-assisted thoracoscopic surgery and posterior spinal fusion for the treatment of Scheuermann's kyphosis. The average age was 17.4 years with closed triradiate cartilage in all. Average follow-up was 2.7 years. An average of 8.3 discs were released anteriorly; an average of 13 levels were fused posteriorly. RESULTS: CONCLUSIONS: Combined video-assisted thoracoscopic surgery release and posterior spinal fusion for the treatment of Scheuermann's kyphosis is a viable option for the treatment of the more severe and rigid curves.
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Authors | José A Herrera-Soto, Shital N Parikh, Mohamed J Al-Sayyad, Alvin H Crawford |
Journal | Spine
(Spine (Phila Pa 1976))
Vol. 30
Issue 19
Pg. 2176-81
(Oct 01 2005)
ISSN: 1528-1159 [Electronic] United States |
PMID | 16205343
(Publication Type: Journal Article)
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Topics |
- Adolescent
- Adult
- Equipment Failure
- Female
- Humans
- Internal Fixators
(adverse effects)
- Kyphosis
(diagnostic imaging, etiology, surgery)
- Male
- Pleural Effusion
(etiology)
- Pneumothorax
(etiology)
- Pulmonary Embolism
(etiology)
- Radiography
- Retrospective Studies
- Scheuermann Disease
(complications)
- Spinal Fusion
(adverse effects)
- Thoracic Surgery, Video-Assisted
(adverse effects)
- Treatment Outcome
- Venous Thrombosis
(complications, etiology)
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