Posterior-only Instrumented Fusion for Treatment of Progressive Thoracolumbar Kyphosis in Mucopolysaccharidosis Bekmez S, Demirkiran G, Olgun D, Dede O,

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Posterior-only Instrumented Fusion for Treatment of Progressive Thoracolumbar Kyphosis in Mucopolysaccharidosis Bekmez S, Demirkiran G, Olgun D, Dede O, Yazici M

Introduction Progressive thoracolumbar kyphosis is a hallmark orthopaedic manifestation of MPS Recommended surgical treatment is circumferential spinal fusion The aim of the study is to report our experience with posterior-only instrumented fusion in MPS kyphosis

Patients and Methods Single institution Between 2008 and patients Demographic data, type of MPS, comorbidities were recorded

Radiographic Analyzes Apical vertebral height (AVH) Presence of any coronal plane deformity Fusion levels Local kyphosis angle (LKA) Proximal and distal junctional kyphosis (PJKA and DJKA)

Results MPS type 3 type VI 1 type I 1 type II 1 type IV Average age at surgery 6.6 years (range, 4 to 12) Average f/u 52.6 months (range, 44 to 64)

Results LKA 63.1° (preop.)  16.6° (postop.)  19.6° (last f/u) No neurological complication or implant failure Adjacent segment problems in 2 patients 1 PJK and 1 DJK

Case 1, 5 y.o., M

Case 2, 8 y.o., M, DJK

Conclusion Adjacent segment problems are not associated with type of fusion Poor bone disease Posterior-only instrumented fusion with pedicle screws in MPS kyphosis is safe and effective Its results appear to be comparable to those achieved with conventional circumferential fusion