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Peer-reviewedCC BY-NCZagazig University Medical Journal

Radiographic Outcomes and Level-Specific Correction of Ponte Osteotomies in Scheuermann Kyphosis: A 24-Patient Randomized Clinical Trail Study

  • Mohamed Mohamed1
  • Wael El mesallamy2
  • Amr El Bakry1
  • Mahmoud Taha3
  • Mahmoud Mahrous Shamloul4
  • Ahmed Salama4
4 affiliations
  1. 1Assistant Professor of Neurosurgery, Faculty of Medicine, Zagazig University, Egypt
  2. 2Professor of Neurosurgery, Faculty of Medicine, Zagazig University, Egypt
  3. 3Professor of Neurosurgery , Faculty of Medicine, Zagazig University, Egypt
  4. 4Lecturer of Neurosurgery, Faculty of Medicine, Zagazig University, Egypt
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Abstract

Background: Ponte posterior column osteotomies are commonly used during posterior fusion to improve sagittal correction in Scheuermann kyphosis; however, correction may differ by vertebral level. This study aimed to evaluate radiographic correction after posterior spinal fusion with Ponte osteotomies, identify levels providing the greatest segmental correction, describe intervertebral disc-height changes, and assess the relationship between anterior disc opening and Cobb-angle improvement. Methods: This randomized clinical trial included 24 patients undergoing posterior spinal fusion with multilevel Ponte osteotomies. Radiographic parameters were assessed preoperatively, immediately postoperatively, and at two years. Osteotomized levels were classified as upper thoracic, middle thoracic, or lower thoracic/thoracolumbar. The relationship between anterior disc opening and segmental correction was assessed using linear correlation. Results: Mean thoracic kyphosis decreased from 79.1±6.2° preoperatively to 45.2±5.4° postoperatively and remained 46.0±5.8° at two years (p<0.001), representing a mean correction of 33.9° (42.9%). The middle thoracic region achieved the greatest correction (7.60°), followed by the lower thoracic/thoracolumbar (5.70°) and upper thoracic regions (2.30°). T8–T9 provided the greatest segmental correction (10.4°). Anterior disc height increased, central height changed minimally, and posterior height decreased. Anterior disc opening correlated positively with segmental correction (R²=0.62). Two patients developed mild wound irritation, with no major neurological or vascular complications or revision surgery. Conclusion: Posterior fusion with Ponte osteotomies produced substantial and durable correction of Scheuermann kyphosis in this paper. Osteotomies located at the apex and adjacent middle thoracic levels yielded the greatest angular benefit, supporting level-targeted correction rather than uniform use across all thoracic segments.

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Cite

BibTeXRIS
BibTeX
@article{mohamed2026radiographic,
  title = {{Radiographic Outcomes and Level-Specific Correction of Ponte Osteotomies in Scheuermann Kyphosis: A 24-Patient Randomized Clinical Trail Study}},
  author = {Mohamed Mohamed and Wael El mesallamy and Amr El Bakry and Mahmoud Taha and Mahmoud Mahrous Shamloul and Ahmed Salama},
  journal = {Zagazig University Medical Journal},
  year = {2026},
  month = oct,
  doi = {10.21608/zumj.2026.530879.4844},
  url = {https://doi.org/10.21608/zumj.2026.530879.4844},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - Radiographic Outcomes and Level-Specific Correction of Ponte Osteotomies in Scheuermann Kyphosis: A 24-Patient Randomized Clinical Trail Study
AU  - Mohamed Mohamed
AU  - Wael El mesallamy
AU  - Amr El Bakry
AU  - Mahmoud Taha
AU  - Mahmoud Mahrous Shamloul
AU  - Ahmed Salama
PY  - 2026
DA  - 2026/10/25
JO  - Zagazig University Medical Journal
DO  - 10.21608/zumj.2026.530879.4844
UR  - https://doi.org/10.21608/zumj.2026.530879.4844
AB  - Background: Ponte posterior column osteotomies are commonly used during posterior fusion to improve sagittal correction in Scheuermann kyphosis; however, correction may differ by vertebral level. This study aimed to evaluate radiographic correction after posterior spinal fusion with Ponte osteotomies, identify levels providing the greatest segmental correction, describe intervertebral disc-height changes, and assess the relationship between anterior disc opening and Cobb-angle improvement. Methods: This randomized clinical trial included 24 patients undergoing posterior spinal fusion with multilevel Ponte osteotomies. Radiographic parameters were assessed preoperatively, immediately postoperatively, and at two years. Osteotomized levels were classified as upper thoracic, middle thoracic, or lower thoracic/thoracolumbar. The relationship between anterior disc opening and segmental correction was assessed using linear correlation. Results: Mean thoracic kyphosis decreased from 79.1±6.2° preoperatively to 45.2±5.4° postoperatively and remained 46.0±5.8° at two years (p<0.001), representing a mean correction of 33.9° (42.9%). The middle thoracic region achieved the greatest correction (7.60°), followed by the lower thoracic/thoracolumbar (5.70°) and upper thoracic regions (2.30°). T8–T9 provided the greatest segmental correction (10.4°). Anterior disc height increased, central height changed minimally, and posterior height decreased. Anterior disc opening correlated positively with segmental correction (R²=0.62). Two patients developed mild wound irritation, with no major neurological or vascular complications or revision surgery. Conclusion: Posterior fusion with Ponte osteotomies produced substantial and durable correction of Scheuermann kyphosis in this paper. Osteotomies located at the apex and adjacent middle thoracic levels yielded the greatest angular benefit, supporting level-targeted correction rather than uniform use across all thoracic segments.
SN  - 2357-0717
SN  - 1110-1431
ER  -