CANTILEVER TECHNIQUE OF SURGICAL REDUCTION AND FIXATION FOR THORACIC KYPHOSIS- A REVIEW OF TECHNIQUE AND RESULTS OF SURGICAL TREATMENT.

Abstract

Scheuermann’s disease is defined as thoracic kyphosis greater than 45° with greater than 5° of anterior wedging in 3 consecutive vertebrae. We describe a new technique for the surgical treatment of thoracic kyphosis. Eleven patients were treated in our series. The average preoperative kyphotic angle was 83.3 degrees (58–94 degrees). Multiple posterior closing wedge osteotomy was performed and four rods (two proximal and two distal) were contoured and fixed to pedicle screws and the deformity reduced by the cantilever technique. The average postoperative kyphotic angle was 41.1 degrees (range 25–54 degrees) giving an average correction of 42.2 degrees per patient. The average postop lumbar angle was 51.8 degrees (range 20–70 degrees). The average follow up time was 25.3 months (range 6–60 months). At follow up the kyphotic angle was found to be 42.8 degrees average (range 24–55 degrees) and the lumbar angle was 57.6 degrees average (range 42–70 degrees). We find this technique simple and effective in reducing curves of high magnitude and the curve was maintained in the long term. Our complication rate was comparable to that quoted in literature. This technique is superior as it avoids sudden stretching of the anterior vasculature and possible rupture of the anterior longitudinal ligament (ALL) and provides correction at multiple levels, avoiding build-up of stress at any single level.