Scheuermann’s Kyphosis: a 39-year follow-up from diagnosis in non-operated patients

Ragborg, Lærke; Dragsted, Casper; Dahl, Benny; Gehrchen, Martin

doi:10.1007/s00586-020-06384-w

Cited by 4 publications

(4 citation statements)

References 19 publications

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“…Inclusion criteria were as follows: (1) diagnosis of SK patients; (2) underwent one-stage posterior spinal fusion (PSF) with multilevel Ponte osteotomies; (3) selecting SSV-1 as LIV; (4) with a minimum follow-up of 2 years. Excluded criteria included: (1) with previous spinal surgical history; (2) with any other spinal deformities; (3) without complete follow-up data. This study was approved by the ethics committee of our hospital (IRB/IEC number: 2021-LCYJ-DBZ-05) and registered at ClinicalTrials.…”

Section: Patients and Groupsmentioning

confidence: 99%

“…S cheuermann kyphosis (SK) is characterized by structural hyperkyphotic deformity that predominantly occurs in adolescence, with a reported incidence of 0.4%$8.3%. [1][2][3] This condition is associated with radiographic features, such as vertebral wedging, irregular vertebral endplate, and Schmorl's node. 3 Posterior-only corrective instrumentation and fusion via multi-level Ponte osteotomy have been the principle treatment of SK patients.…”

Section: Introductionmentioning

confidence: 99%

“…Scheuermann kyphosis (SK) is characterized by structural hyperkyphotic deformity that predominantly occurs in adolescence, with a reported incidence of 0.4%~8.3%. 1 , 2 , 3 This condition is associated with radiographic features, such as vertebral wedging, irregular vertebral endplate, and Schmorl's node. 3 Posterior‐only corrective instrumentation and fusion via multi‐level Ponte osteotomy have been the principle treatment of SK patients.…”

Section: Introductionmentioning

confidence: 99%

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Selecting the Vertebra above Sagittal Stable Vertebra as the Distal Fusion Level in Scheuermann's Kyphosis: A Prospective Study with a Minimum of 2‐Year Follow‐Up

Xu,

Ling,

et al. 2023

Orthopaedic Surgery

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ObjectiveThe proper selection of the lower instrumented vertebra (LIV) remains controversial in the surgical treatment of Scheuermann's disease and there is a paucity of studies investigating the clinical outcomes of fusion surgery when selecting the vertebra one level proximal to the sagittal stable vertebra (SSV‐1) as LIV. The purpose of this study is to investigate whether SSV‐1 could be a valid LIV for Scheuermann kyphosis (SK) patients with different curve patterns.MethodsThis was a prospective study on consecutive SK patients treated with posterior surgery between January 2018 and September 2020, in which the distal fusion level ended at SSV‐1. The LIV was selected at SSV‐1 only in patients with Risser >2 and with LIV translation less than 40 mm. All of the patients had a minimum of 2‐year follow‐up. Patients were further grouped based on the sagittal curve pattern as thoracic kyphosis (TK, n = 23) and thoracolumbar kyphosis (TLK, n = 13). Radiographic parameters including global kyphosis (GK), lumbar lordosis (LL), sagittal vertical axis (SVA), LIV translation, pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS) were measured preoperatively, postoperatively, and at the latest follow‐up. The intraoperative and postoperative complications were recorded. The Scoliosis Research Society (SRS)‐22 scores were performed to evaluate clinical outcomes.ResultsA total of 36 patients were recruited in this study, with 23 in the TK group and 13 in the TLK group. In TK group, the GK was significantly decreased from 80.8° ± 10.1° to 45.4° ± 7.7° after surgery, and was maintained at 45.3° ± 8.6° at the final follow‐up. While in the TLK group, GK was significantly decreased from 70.7° ± 9.2° to 39.1° ± 5.4° after surgery (p < 0.001) and to 39.3° ± 4.5° at the final follow‐up. Meanwhile, despite presenting with different sagittal alignment, significant improvement was observed in LL, SVA, and LIV translation for both TK and TLK groups (p < 0.05). Self‐reported scores of pain and self‐image in TK group and scores of self‐image and function in TLK group showed significant improvement at the final follow‐up (all p < 0.05). Distal junctional kyphosis (DJK) was observed in two patients (8.7%) in TK group, and one patient (7.7%) in TLK group. No revision surgery was performed.ConclusionSelecting SSV‐1 as LIV can achieve satisfactory radiographic and clinical outcomes for SK patients with different curve patterns without increasing the risk of DJK. This selection strategy could be a favorable option for SK patients with Risser sign >2 and LIV translation less than 40 mm.

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Section: Patients and Groupsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Selecting the Vertebra above Sagittal Stable Vertebra as the Distal Fusion Level in Scheuermann's Kyphosis: A Prospective Study with a Minimum of 2‐Year Follow‐Up

Xu,

Ling,

et al. 2023

Orthopaedic Surgery

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“…Murray et al described how the curvatures below 85° do not impair pulmonary function, while kyphotic curvatures over 100° and with an apex in the uppermost eight thoracic vertebral bodies exhibit a significant restrictive ventilation disorder [ 82 ]. Ragborg et al observed a significant reduction in quality of life compared to the general population in a cohort with a 39-year follow-up [ 83 ]. Garrido et al described a worsening of the kyphosis angle of 0.45° annually and a deterioration of the Oswestry Disability Index (ODI) compared to the general population in a cohort of untreated SD patients with a 27-year follow-up [ 84 ].…”

Section: Scheuermann’s Diseasementioning

confidence: 99%

Surgical Treatment of Spinal Deformities in Pediatric Orthopedic Patients

Braun

Brenneis

Schönnagel

et al. 2023

Life

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Scoliosis and Scheuermann’s disease are common spinal deformities that affect a substantial population, particularly adolescents, often impacting their quality of life. This comprehensive review aims to present a detailed understanding of these conditions, their diagnosis, and various treatment strategies. Through an extensive exploration of current literature, the review discusses the etiology of these spinal deformities and the use of diagnostic tools such as X-rays and MRI. It further delves into the range of treatment options available, from conservative approaches such as physiotherapy and bracing to more invasive surgical interventions. The review underscores the necessity of an individualized treatment approach, taking into account factors such as the patient’s age, the severity of the curvature, and overall health. This all-encompassing perspective on scoliosis and Scheuermann’s disease will aid in evidence-based decision making in their management with the goal of improving patient outcomes.

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