Reinhardt P, Bassett G S
Alfred I. duPont Institute, Wilmington, Delaware 19899.
J Spinal Disord. 1990 Jun;3(2):162-8.
Six of 14 patients surgically treated for Scheuermann's disease developed a short segmental kyphosis adjacent to the fusion. In four patients, the original fusion had incorporated the end vertebrae of the curves. However, there was mild wedging of the end vertebra, which led to a loss of correction occurring at the junction between fused and unfused segments. These losses averaged 13 degrees (range, 6-29 degrees) at follow-up, ranging from 1 to 5.5 years (average, 2.8 years). The resultant short segmental kyphosis ranged in magnitude from 15 degrees to 34 degrees (average, 23 degrees). The kyphosis occurred distally in five patients and proximally in one patient. The risk of developing a short segmental kyphosis may be minimized if the fusion and instrumentation extend beyond all wedged vertebrae to the first "square" vertebra. This will necessitate fusing into the upper lumbar spine for many patients.
14例接受施莫尔氏病手术治疗的患者中有6例在融合部位附近出现了短节段后凸畸形。4例患者的初始融合包含了弯曲的终末椎体。然而，终末椎体存在轻度楔形变，导致在融合节段与未融合节段的交界处出现矫正丢失。随访时这些丢失平均为13度（范围为6 - 29度），随访时间为1至5.5年（平均2.8年）。由此产生的短节段后凸畸形程度在15度至34度之间（平均23度）。5例患者的后凸畸形发生在远端，1例发生在近端。如果融合和内固定延伸至所有楔形变椎体以外至第一个“方形”椎体，则发生短节段后凸畸形的风险可能会降至最低。这对于许多患者而言将需要融合至上腰椎。
