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Abstract

Scheuermann kyphosis debuts in young adolescents and it is defined as a fixed hyperkyphosis >40º Cobb, with associated anterior wedging of vertebral endplates of >5º in three or more adjacent vertebrae. It is thought to be caused by mechanical stress on structurally deficitary vertebral endplates. For its diagnosis, clinical history and plain radiographs are used, but also MRI when there is neurological affection. Treatment depends on the severity of the curve: those <60º can be treated orthopedically with Milwaukee bracing in combination with rehabilitation treatment (stretching or muscle strengthening) and postural hygiene. If >70º, surgical treatment is indicated using a posterior-only approach, as it reduces de apparition of complications when compared with anterior and combined approach. Vertebral osteotomies will be made depending on the DAR. We will use pedicular screws and bars, and transverse hooks to end instrumentation, as we attach distally the SSV and proximally the first kyphotic vertebra, to avoid revision surgery. Among the complications (14%) we find surgical site infection (up to 10%), neurological injury (8%), or pulmonary complications derived from anterior approach (20%). Habrá que hacer, por tanto, un balance global del paciente y de su equilibrio sagital para garantizar un resultado óptimo.