When is surgery indicated for kyphosis?

Updated: May 04, 2020
  • Author: R Carter Cassidy, MD; Chief Editor: Jeffrey A Goldstein, MD  more...
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Indications for treatment of kyphosis include the following:

  • Unremitting pain
  • Neurologic changes
  • Progression of deformity [36]
  • Cosmesis [4]

Indications for surgical treatment of Scheuermann kyphosis have changed fairly substantially; however, precise indicators have not been elucidated.

Authors from early clinical series simply cited pain and deformity as reasons to perform fusion. Proposed indications more specific than these are as follows [37] :

  • Kyphosis greater than 75°
  • Kyphosis greater than 65° with pain
  • Unacceptable appearance of the trunk

Other possible indications in severely affected patients are problems with balance while sitting and skin problems due to pressure at the apex of the deformity.

Surgical intervention for posttraumatic kyphosis is recommended in the following circumstances [38] :

  • The patient's neurologic status changes
  • The condition progresses
  • Kyphosis is 30° or more
  • Loss of anterior vertebral height exceeds 50%

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