• Hakan Akgün, Akif Albayrak, Deniz Kargın, Ali Öner, Deniz Akbulut, and Abdurrahman Aydın.
• Tatvan Can Hospital, Bitlis, Turkey. md.hakanakgun@gmail.com.
• Eur Spine J. 2025 Feb 8.

PurposeThis study aimed to evaluate the clinical and radiological outcomes of two patient groups with congenital kyphosis and kyphoscoliosis who underwent posterior surgical correction using Schwab grade 3-4 and Schwab grade 5-6 osteotomies.MethodsA retrospective analysis was conducted on 58 patients (35 females and 23 males; mean age: 16.2 yr). Radiological evaluations included preoperative,postoperative,and last follow-up measurements of segmental kyphosis, scoliosis, lumbar lordosis(LL), C7-central sacral vertical line[C7-CSVL] and sagittal vertical axis [SVA], and pelvic parameters (pelvic incidence [PI],pelvic tilt [PT], sacral slope [SS].Clinical evaluations included Scoliosis Research Society-22r (SRS-22r) scores and Oswestry Disability Index (ODI) scores at preoperative and last follow-up time points.ResultsThe mean deformity correction was 53.4%. Preoperative segmental kyphosis angles for Schwab grade 3-4 osteotomy (group 1) and Schwab grade 5-6 osteotomy (group 2) were 66.9° and 104.9°, respectively.The last follow-up angles were 33.1° and 48.2° (p < 0.001).No significant loss of correction was observed in either group (p > 0.05). SRS-22r scores improved significantly at the last follow-up (p < 0.001).Similarly, ODI scores improved significantly in both groups (p < 0.001).Neurological complications occurred in 14 (24.1%) patients,including dura injury, spinal nerve root injury, transient incomplete neurological deficits, and spinal cord compression.Mechanical complications were reported in 14 (24.1%) patients and included rod fractures, proximal junction kyphosis, pedicle screw malposition, and pedicle screw loosening.ConclusionPosterior surgical correction using Schwab grade 3-4 and Schwab grade 5-6 osteotomies yields satisfactory radiological and clinical outcomes in patients with congenital kyphosis and kyphoscoliosis. However, higher osteotomy grades, necessitated by greater deformity severity, are associated with increased complication rates.© 2025. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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