Background: Surgical treatment of Scheuermann's kyphosis is tailored individually and may be considered in patients whose back pain cannot be relieved with conservative methods. Junctional kyphosis is a frequent complication that can arise either proximally or distally to the instrumentation. This study aimed to assess the clinical and radiological outcomes after restoration the spinopelvic parameters of sagitally corrected patients with Scheuermann's kyphosis.

Subject & Methods: We carried out this prospective cohort study on 12 cases with Scheuermann's kyphosis at Zagazig University Hospitals and treated by posterior approach, pedicular screw fixation, the required osteotomy according to type of the deformity. Follow up is done postoperatively, 3,6, 12 and 24 months by Oswestry Disability Index (ODI) score, and by radiological evaluation in lateral standing position.

Results: There were direct significant correlations between pre and postoperative ODI, visual analogue score (VAS), lumbar lordosis (LL) angle, thoracolumbar kyphosis (TLK) angle, thoracic kyphosis (TK) angle, pelvic Incidence – lumbar lordosis mismatch (PI-LL) with P value <0.001 for each, also there was a direct significant correlation between pre and postoperative Sagittal Imbalance (P value = 0.001).

Conclusion: Ponte technique was found to be useful in correction of Scheuermann's Kyphosis cases. The combination technique improved the maintenance of the kyphosis correction to a small but noticeable degree. Proximal junctional radiographic kyphosis was prevalent and appeared to be related to both large curve magnitudes before and after surgery and to pelvic incidence.