Introduction The selection of fusion levels in thoracic kyphosis been controversial, the incidence of juvenile kyphosis ranges from 1 to 8% being more common in males. Patients and Methods This study is a retrospective study case series type, level of evidence IV. We evaluated 15 patients with Scheuermann disease treated with posterior transpedicular fixation and osteotomies. Overall, two cases were excluded for not meeting the minimum monitoring time 2 years. The average age at time of surgery was 16.2 years. Patients were evaluated clinically and radiologically pre- and postsurgery to assess results and determine common factors of complications. Results In the series studied found that the percentage correction achieved was 49%, with a loss of correction 3 degrees at follow-up, the incidence of PJK was 23%, two of three patients presented the following factors in common: apex above T5, cervical hyperlordosis, SVA more than 4 cm, increased pelvic incidence, stiffness deformity, proximal fixation with hooks above T3, in the third case ended with pedicle screws. Conclusion Transpedicular fixation system and posterior spinal osteotomy is effective for the treatment of kyphosis by Scheuermann disease; the power of this type of correction techniques may arise in the pediatric population increased incidence of proximal junction kyphosis in patients with highest apex, curve stiffer, cervical hyperlordosis, and lower percentage of correction.

Introduction Complications in the treatment of patients with early-onset deformities is a very common situation. When the surgeon assumes the treatment of this disease, he should try to gain control of the spinal deformity and obtain proper growth of thorax. The main goal of the treatment is to achieve these two aspects, with the lowest incidence of complications for the patient. Patients and Methods This is a retrospective study case series and the level of evidence is IV. We evaluated 13 patients treated with surgical techniques and growth distraction without fusion (MMC 5p, 2p idiopathic infantile scoliosis, spinal dysplasia 1p, 1p SCIWORA, Marfan syndrome 1p, 1p Escobar syndrome, Neurofibromatosis Type I 1p, 1p Thoracogenic scoliosis). The average age at the time of surgery was 4.10 years. The average preoperative angular value was 83.7 degrees (range, 50–135 degrees). We analyzed the following: (1) Risk factors preoperative; (2) Type of mounting; (3) Sequence of distractions; (4) Complications. Results Overall, 13 patients underwent 27 procedures of distraction. Analyzing each case, in particular, we have seen that the frequency of distractions averaged was a procedure each 11 months (range, 7–17 months), and 23% of these patients currently reached last surgery (spinal fusion) after 3.5 years of treatment with distractions (range, 2.10–3.10). In 13 patients, we observed complications in 69% during treatment. Our complications were as follows: (1) superficial infections 6.6%, (2) deep infections 10%, (3) rib fractures 10%, (4) spontaneous fusion 3.3%, and (5) prosthetic loosening. Conclusions In treatment of early onset deformities, the spinal surgeon should be prepared to deal different complications during treatment. On the basis of our experience, we consider it a high-risk pathology.