Introduction: Patients with long-standing thoracolumbar kyphosis are challenging, and if not treated adequately, they are associated with long-term morbidity. With advancements in technology, these deformities are now amenable to successful correction. We evaluated the functional outcome of surgical management in patients with thoracolumbar kyphosis treated through only a posterior approach.

Materials and Methods: Twenty-two patients with either thoracic or thoraco-lumbar kyphosis, who met our inclusion and exclusion criteria, were recruited for our study. All patients underwent clinical, radiological, and neurological evaluations. Pre-operatively, all patients underwent full-spine X-rays and MRI. The Pre-operative Visual Analog Scale (VAS) score, Frankel score, and Oswestry Disability Index (ODI) were assessed. All patients received management via a posterior approach with osteotomy, with or without anterior column support, and posterior instrumentation. All patients were followed up for at least two years. Changes between the baseline and final follow-up were assessed.

Results: The average surgical duration was 236 minutes, with an average intraoperative blood loss of 750.5 ml. At the two-year final follow-up, there was a statistically significant improvement in Cobbs' angle, VAS, and ODI. Postoperatively, three patients experienced superficial infections that were treated with extended antibiotics. A transient neurological deficit was observed in three patients, and two patients experienced significant post-operative radicular pain, which was managed conservatively. There were no long-term neurological complications, implant breakage, or deterioration in Cobbs' angle.

Conclusion: The surgical treatment of thoraco-lumbar kyphosis through a posterior approach is an effective method with minimal complications, lesser morbidity and good functional outcomes. Keywords: Oswestry Disability Index, Oswestry Disability Index (ODI), Thoraco-lumbar Kyphosis.