The effectiveness of a low implant density in Scheurmann kyphosis in correcting the lumbar lordosis -pelvic incidence mismatch

Abstract

Purpose To evaluate the effectiveness of using a low implant density in surgical treatment of Scheurmann Kyphosis (SK) in correcting the lumbar lordosis (LL)- Pelvic incidence (PI) mismatch. Methods Patients that were surgically treated for SK by a low screw density with multiple Ponte osteotomies at two institutions from January 2021 to January 2022 were identified and included in the study. Preoperative/postoperative/1- and 2-year follow-up measurements were analyzed from full-spine standing radiographs. Results Thirty patients were enrolled in our study, mean age 20.5 (13–37) years, mean preoperative kyphosis was 85.9 (75–108), a mean preoperative lumbar lordosis-pelvic LL-PI mismatch was 25.9 (23–28). The maximum kyphosis was corrected to 46.2 (37–63) and the LL-PI mismatch was reduced to 7.7. The correction was maintained at 1- and 2-years follow-up with no statistical change in the sagittal angles. Conclusion Surgical correction of SK using low-density implants and multiple Ponte osteotomies is an effective method of correcting the kyphotic deformity and reducing the LL-PI mismatch to normal physiological values.