Hugh Door's Disease Kyphosis Surgery

ObjectiveThe purpose of the current retrospective review is to evaluate the clinical diagnosis,manifestation and differential operative treatments for the kyphosis of Scheuermann's disease and analyze its clinical outcomes as well. The summary can be used and helpful for the future clinical work.MethodsThis is a retrospective study of nine patients of Scheuermann's disease, including eight males and one females with an average age of fifteen years (thirteen-eighteen years), who underwent One-stage spinal posterior operations from January 2002 to December 2009. The kyphosis Cobb's angle in the sagittal plane, clinical manifestation were evaluated both before and after operation. In the group, all nine patients with apparent clinical symptom; two patients with abnormal pulmonary function; one patient with family history; five patients with scoliosis.ResultsAll nine patients underwent one-stage spinal posterior operations successfully, and recovered smoothly without complications. Three patients underwent spinal posterior correction, internal fixation and bone graft fusion; six patients underwent spinal posterior osteotomy correction, internal fixation and bone graft fusion, including two patients underwent Smith Peterson osteotomy correction, two patients underwent pedicle subtraction osteotomy correction, and two patients underwent sandwich osteotomy correction. There are seven patients followed-up, the median follow-up was twenty-seven months (three-eighty eight months). The mean kyphosis Cobb's angle in the sagittal plane changed from 68°to 29°. The correction rate was about 55% (35%-100%). The kyphosis Cobb's angle on the final follow-up was 30°(5°-58°), and the mean lost angle was 1°. All patients, who had chronic back pain and fatiguability, refractory to conservative treatment, but improved considerably after operation.ConclusionOne-stage spinal posterior operation with three dimensional corrective instrumentation can be used effectively for the correction of kyphosis of Scheuermann's disease and the improvement of clinical symptoms, especially for using osteotomy correction. It is helpful for holding correction with plaster cast immobilization for at least three months, appropriate fusion level and sufficient area bone graft fusion.