Folia medica
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To analyze the efficacy of the method for selecting the distal level of fusion in treatment of thoracic hyperkyphosis in patients with Scheuermann's disease. ⋯ A distal level of instrumentation ending at the first lordotic vertebra is not justified and causes violation of sagittal balance and development of distal junctional kyphosis. The inclusion of a sagittal stable vertebra in fusion prevents the development of this undesirable situation.