The surgical management of scheurmann’s kyphosis: Efficacy and safety of a low density posterior pedicle screw construct

Background: To see if employing a low pedicle screw density in the posterior therapy of Scheuermann kyphosis is safe, radiologically effective, and clinically effective. Methods: Patients with Scheuermann kyphosis underwent posterior surgical correction between 2016 and 2019. Low Screw Density, peri apical Ponte osteotomies and cantilever correction maneuver were our surgical technique for deformity correction. Two observers performed a radiological evaluation of the before and postoperative Spinopelvic parameters. Validated Arabic version of Scoliosis Research Society 22 questionnaire were used to assess the preoperative and postoperative clinical results. Cost saving analysis was performed. Results: This study enlisted the participation of thirty patients. The patients mean age 21.8 ±3.4 years and mean follow up 34.8±7.9 months. The mean surgical time was 165.33 ±17.9 minutes , the mean number of osteotomies was 4.2± 0.8 , and the mean blood loss was 770± 139.3cc.The mean preoperative dorsal kyphosis 87.5°±4.6 °and the mean postoperative dorsal kyphosis 43.1°± 3.7° at final follow up (P<0.001).The mean preoperative scoliosis research society 22 questionnaire 2.8±0.4 and the mean postoperative scoliosis research society 22 questionnaire 4.3±0.8 at final follow up (P<0.001). Conclusions: Posterior Surgical Intervention with low Screw Density construct and periapical Ponte osteotomies is safe , radiologically , clinically and cost effective way in surgical management of Scheuermann kyphosis. Study Design: Prospective Cohort Study. Level of Evidence: Level IV.