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Posterior-only versus combined anterior/posterior fusion in Scheuermann disease: a large retrospective study

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Abstract

Purpose

The literature shows controversies concerning surgical treatment of Scheuermann’s kyphosis between posterior-only fixation and combined anterior/posterior fusion. The aim of this study is to compare the clinical and radiological results and the rate of complications between these two techniques.

Methods

We performed a multicentric retrospective review of 131 patients who underwent primary fusion for Scheuermann’s kyphosis divided into two groups: 67 patients operated via posterior approach only and 64 operated via combined anterior/posterior approach.

Classical clinical, surgical and radiological data were collected. A descriptive and statistical analysis was performed between the two groups to evaluate the influence of the surgical procedure on the rate of complications, the functional results and radiological correction.

Results

The average age was 23 and the average kyphosis was 77 degrees. The mean follow-up was 4.2 years (range 0.1–27.3). There was no difference regarding demographic data, preoperative radiographic data and length of fusion between the two groups. Functional results were good in 81% of cases. Kyphosis correction was on average 15° and the correction of the compensatory lumbar lordosis was 20°. The correction was stable at final follow-up. There was no difference between the two groups in terms of functional results, the complications rate and radiological correction.

Conclusion

Surgery for Scheuermann’s kyphosis gives good and stable functional and radiological results. Given the fact that the two surgical strategies give the same results, it appears that the anterior/posterior fusion technique to treat Scheuermann’s kyphosis should be reserved for major deformations.

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Authors and Affiliations

  1. Groupe Hospitalier Paris Saint-Joseph, 185, rue Raymond Losserand, 75014, Paris, France

    Guillaume Riouallon & Stéphane Wolff

  2. Hopale/Institut Calot, Berck/Mer, France

    Christian Morin

  3. Service de Chirurgie Orthopédique du Rachis et de Traumatologie du Sport, Hôpital Civil, Pavillon Chirurgical B, 1, place de l’Hôpital, 67091, Strasbourg Cedex, France

    Yann-Philippe Charles

  4. Des Massues Surgical Center, 92, rue Edmond-Locard, 69322, Lyon, France

    Pierre Roussouly

  5. Hôpital Hôtel-Dieu de France, Université Saint-Joseph, Beyrouth, Lebanon

    Gaby Kreichati

  6. Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France

    Ibrahim Obeid

Authors
  1. Guillaume Riouallon
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  2. Christian Morin
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  3. Yann-Philippe Charles
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  4. Pierre Roussouly
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  5. Gaby Kreichati
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  6. Ibrahim Obeid
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  7. Stéphane Wolff
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Consortia

French Scoliosis Study Group

Corresponding author

Correspondence to Guillaume Riouallon.

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All authors declare that they have no conflict of interest.

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Riouallon, G., Morin, C., Charles, YP. et al. Posterior-only versus combined anterior/posterior fusion in Scheuermann disease: a large retrospective study. Eur Spine J 27, 2322–2330 (2018). https://doi.org/10.1007/s00586-018-5633-x

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  • DOI: https://doi.org/10.1007/s00586-018-5633-x

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