A 29 year old female firefighter, diagnosed with progressive Scheurmann's Kyphosis. She presented status post surgery T12-L1 for trauma. Dr. Pashman treated the patient with a Posterior Spinal Fusion from T2 to L2.

1. Case Review:
29 year old female
firefighter, with
75° progressive Schuermann’s
Kyphosis, status post
spinal fusion from T12-L1
Robert S Pashman, MD
Scoliosis and Spinal Deformity Surgery
www.eSpine.com

2. Patient History
• 29-year-old female
• Status post a thoracoabdominal approach and interbody fusion
of T12-L1 for diskogenic disease, positive diskogram, and
thoracolumbar degeneration and pain status post trauma.
• Patient is a fire fighter by occupation
• Now she is found to have progressive Scheuermann's kyphosis
measuring 75° of the thoracic spine.
• The patient has failed conservative therapy.

3. Pre-op X-rays
Classic Scheuermann's
identified with multiple-level
vertebral body wedging and
degeneration of the thoracic
75° spine causing severe upper mid-
scapular pain with radiation to
the thoracic, thoracolumbar,
and cervical spine.

4. Indications for Surgery
1. A 75° progressive Scheuermann's kyphosis of thoracic spine.
2. Status post abdominal retroperitoneal approach and interbody
fusion, T12-L1.
3. Now with increasing low back pain due to hyperlordosis cervical,
hyperlordosis lumbar and progressive thoracic kyphosis.
4. Failed conservative therapy with physical therapy and medication
treatment.
5. Multiple-level degenerative disk disease of thoracolumbar spine
due to Scheuermann's kyphosis.

5. Surgical Strategy
• Thoracic 2 to lumbar 2 segmental spinal instrumentation using
titanium cobalt chromium pedicle screw 5.5 rod construct.
• Multiple-level Smith-Petersen osteotomy for mobilization of a
rigid Scheuermann's kyphosis at T3-T4, T4-T5, T5-T6, T6-T7,
T7-T8, T8-T9, T10-T11, and T12-L1.
• Posterior spinal fusion using locally harvested autogenous bone
and allograft, T2-L1.
• Multiple-level facetectomy for mobilization of thoracic spine T3-
L1.
• Intraoperative neuronavigation using O-ARM Treon S7 Stealth
device.
• Intraoperative motor evoked potential monitoring.
• Plastic closure of wound.

6. Post-op Films
30°
The curvature was reduced
from 75° to 30° while
maintaining the coronal and
sagittal balance.

7. Pre-Op/Post-op Comparison
75° 30°