Scheuermann’s Disease: The Lumbar Variant

Osteochondroses: a clinical review for the pediatrician

The purpose of this article is to provide the pediatrician with a thorough review of the variety of osteochondroses that affect children and adolescents. These conditions present in all different parts of the body in a wide range of patients: from the sedentary to athletic, the toddler to the pre-teen.The osteochondroses often are self-limiting and resolve with nonoperative management, but there are a few circumstances when operative treatment may be required. Recent literature confirms the heterogeneity of these conditions with respect to the clinical presentations and musculoskeletal manifestations.We think this article will heighten awareness of these disorders in the pediatric community, so that prompt intervention may be rendered.

MULTIPLE SEGMENTAL OSTEOTOMIES TO THE KYPHOSIS CORRECTION

OBJECTIVE

To evaluate the results of the surgical treatment of the spinal Kyphosis using the Ponte's technique (multiple posterior osteotomies).

METHODS

Ten patients (8 with Scheuermann's kyphosis and 2 with kyphosis after laminectomy) submitted to surgical correction of kyphotic deformity greater than 70° were retrospectively assessed. The age at the surgical time ranged from 12 to 20 years old (mean age16.8 years ± 2.89). The radiographic parameters evaluated were the kyphosis, the lordosis and the scoliosis - whenever present. The presence of proximal and distal junctional kyphosis, loss of correction, and complications as implants loosening and breakage were also assessed. The radiographic parameters were evaluated at the preoperative, early postoperative and late postoperative time.

RESULTS

The patients were followed through a period that ranged from 24 to 144 months (65.8 ±39.92). The mean value of the kyphosis was 78.8° ± 7.59° (Cobb) before surgery and 47.5° ± 12.54° at late follow up, with mean correction of 33.9° ± 9.53° and lost correction of 2.2°.

CONCLUSION

The surgical treatment of the thoracic kyphosis using multiples posterior osteotomies presented a good correction of the deformity and minimal lost of correction during follow up.