-
The Journal of Bone and Joint Surgery.... Jul 1990
Review
Topics: Adolescent; Adult; Braces; Diagnostic Imaging; Electric Stimulation Therapy; Exercise Therapy; Humans; Physical Examination; Scheuermann Disease; Spinal Fusion
PubMed: 2195036
DOI: No ID Found -
European Spine Journal : Official... Mar 2017Anterior release for Scheuermann's disease was considered an important technique for decades. However, posterior-only surgery for Scheuermann's disease has shown a... (Meta-Analysis)
Meta-Analysis Review
PURPOSE
Anterior release for Scheuermann's disease was considered an important technique for decades. However, posterior-only surgery for Scheuermann's disease has shown a promising potential to manage this deformity, as well. Correction loss could happen post-operatively, especially when posterior-only surgery is performed in the early days. Therefore, a dispute regarding anterior release for Scheuermann's disease exists.
METHODS
We performed a systematic review of studies, reporting the outcomes of anterior release and posterior fusion surgery (AP group) or posterior-only surgery (PO group) for Scheuermann's disease. Data pooling and a meta-analysis with a random-effects model were performed to evaluate the results.
RESULTS
Twenty-three studies met the inclusion criteria. The pooled correction loss of Cobb angle for the AP group was 4.1(3.4, 4.8), and for the PO group, it was 3.8(3.3, 4.4). The overall effects of blood loss, surgery time, proximal junctional kyphosis (PJK), distal junctional kyphosis (DJK), self-image improvement, pain relief, and return-to-surgery were compared between the two groups.
CONCLUSIONS
A systematic review of the outcomes of Scheuermann's disease demonstrated a very similar correction loss for the AP group and the PO group. A meta-regression supported that correction loss did decrease as time moved on for the PO procedure, which could be explained by the improvements to instrumentation and techniques. For other outcomes, the PO group showed advantages in blood loss, surgery time, and junctional kyphosis. Similar outcomes were observed in relation to aspects of cosmetic improvement and pain relief for the AP and PO groups. The revision rate was mildly lower in the PO group than in the AP group.
Topics: Blood Loss, Surgical; Humans; Operative Time; Scheuermann Disease; Spinal Fusion; Treatment Outcome
PubMed: 27384777
DOI: 10.1007/s00586-016-4632-z -
BioMed Research International 2013The mode of Scheuermann's disease inheritance and its phenotypic traits in probands and their relatives were studied in 90 pedigrees (90 probands and 385 relatives). The... (Review)
Review
The mode of Scheuermann's disease inheritance and its phenotypic traits in probands and their relatives were studied in 90 pedigrees (90 probands and 385 relatives). The disorder was identified as a genetically related pathology inherited by autosomal dominant type, controlled by a mutant major gene, as a kyphotic deformity without signs of vertebral bodies' anomaly and torsion. Morphological and biochemical studies showed disturbance in the structure of vertebral growth plate anterior aspects at the level of deformity, defects in proliferation and differentiation of chondrocytes, and change in proteoglycan spectrum in cells and matrix. Twelve candidate genes were studied in chondrocytes isolated from vertebral growth plates of patients with Scheuermann's disease. The study results included disorder in the IHH gene expression and preservation of the expression of PAX1, two aggrecan isoforms, link protein, types I and II collagen, lumican, versican, growth hormone and growth factor receptor genes, and proliferation gene. Preservation of the SOX9 gene (transcription gene) probably indicates posttranscriptional genetic disorders. The study is under way.
Topics: Adult; Aged; Cell Differentiation; Cell Proliferation; Chondrocytes; Female; Genetic Association Studies; Growth Plate; Hedgehog Proteins; Humans; Male; Middle Aged; Paired Box Transcription Factors; Scheuermann Disease
PubMed: 24102061
DOI: 10.1155/2013/973716 -
Clinics in Sports Medicine Apr 1986Confusion over dorsolumbar kyphosis and Sheuermann's disease has existed in the literature since the first recorded episodes in 1921. The present article delineates an... (Review)
Review
Confusion over dorsolumbar kyphosis and Sheuermann's disease has existed in the literature since the first recorded episodes in 1921. The present article delineates an etiology of back pain that is frequently seen in the adolescent population and is not to be confused with the painless fixed kyphotic deformity so frequently mentioned in the scoliosis literature. These patients with a painful dorsolumbar Sheuermann's disease may well have a traumatic herniation of the disk into the bony vertebral body. This type of x-ray and clinical finding should become familiar to all clinicians dealing with an adolescent population.
Topics: Adolescent; Adult; Back Pain; Child; Diagnosis, Differential; Humans; Middle Aged; Movement; Radiography; Scheuermann Disease
PubMed: 2937556
DOI: No ID Found -
European Spine Journal : Official... Feb 2020Opposed to proximal junctional kyphosis and proximal junctional failure, their distal equivalents, distal junctional kyphosis and failure (DJK/DJF) have received less... (Review)
Review
BACKGROUND
Opposed to proximal junctional kyphosis and proximal junctional failure, their distal equivalents, distal junctional kyphosis and failure (DJK/DJF) have received less attention in the literature. The aim of this article is to provide an overview of the problem of DJK-DJF in different clinical scenarios such as adolescent idiopathic scoliosis (AIS), Scheuermann's kyphosis (SK) and adult deformity surgery and to suggest a strategy for prevention and treatment.
METHODS
A narrative review of the literature was conducted to identify the best evidence on the risk factors of the problem.
RESULTS
DJK/DJF have been described as a complication of AIS, SK and adult spine deformity (ASD). For AIS and SK, the choice of a lower instrumented vertebra more cranial than the sagittal stable vertebra has shown to increase the incidence of DJK and DJF. For ASD, constructs ending with S1 pedicle screws had a higher incidence of DJK/DJF than those ending distally with S1 pedicle plus iliac screws.
CONCLUSION
The proposed strategy of treatment includes restoration of normal sagittal alignment, choice of a distal fixation point stable in the sagittal, coronal and transverse planes, balancing the fusion mass over the distal fixation point and providing solid fixation at the distal end of the construct. These slides can be retrieved under Electronic Supplementary Material.
Topics: Humans; Incidence; Kyphosis; Pedicle Screws; Reoperation; Scheuermann Disease; Scoliosis; Spine
PubMed: 31993790
DOI: 10.1007/s00586-020-06304-y -
Rheumatism Apr 1949
Topics: Humans; Scheuermann Disease; Spinal Curvatures; Spine
PubMed: 18118833
DOI: No ID Found -
Orthopedic Nursing
Topics: Humans; Scheuermann Disease; Radiography; Spinal Fusion
PubMed: 36702098
DOI: 10.1097/NOR.0000000000000923 -
Acta Orthopaedica Oct 2011The genetic/environmental etiology of Scheuermann's disease is unclear. We estimated the heritability of the disease using an etiological model adjusted for sex and time...
BACKGROUND AND PURPOSE
The genetic/environmental etiology of Scheuermann's disease is unclear. We estimated the heritability of the disease using an etiological model adjusted for sex and time of diagnosis, and examined whether the prevalence of Scheuermann's disease was constant over time.
METHODS
46,418 twins were sent a questionnaire about health and disease. Of these, 75% returned the questionnaire and 97% answered the question "Have you been diagnosed as having Scheuermann's disease by a doctor?"
RESULTS
Responders included 11,436 complete pairs of twins. Data were analysed using classical twin modeling methods. Tetrachoric correlations were used to decide which etiological model to fit. The best-fitting model was the AE model. Heritability was 0.74 (95% CI: 0.65-0.81), while variance explained by environmental factors was 0.26 (95% CI: 0.19-0.35). A threshold of 2.1 (95% CI: 1.9-2.2) was calculated, corresponding to a prevalence of 1.9% (95% CI: 1.3-2.8) for women. Regression coefficients for age and sex were 0.000 (95% CI: -0.003 to 0.002) and -0.32 (95% CI: -0.42 to -0.23).
INTERPRETATION
We found a heritability of 0.74 in Scheuermann's disease. The threshold in men was lower than in women, corresponding to a male prevalence that was almost twice that of females. We found no change in the prevalence of Scheuermann's disease throughout the 50-year age span that we examined.
Topics: Adult; Aged; Aged, 80 and over; Denmark; Diseases in Twins; Female; Humans; Male; Middle Aged; Prevalence; Registries; Scheuermann Disease; Sex Factors; Surveys and Questionnaires
PubMed: 21895506
DOI: 10.3109/17453674.2011.618919 -
Praxis Nov 1968
Topics: Humans; Scheuermann Disease
PubMed: 5757463
DOI: No ID Found -
The Journal of Bone and Joint Surgery.... Jul 2011This review of the literature presents the current understanding of Scheuermann's kyphosis and investigates the controversies concerning conservative and surgical... (Review)
Review
This review of the literature presents the current understanding of Scheuermann's kyphosis and investigates the controversies concerning conservative and surgical treatment. There is considerable debate regarding the pathogenesis, natural history and treatment of this condition. A benign prognosis with settling of symptoms and stabilisation of the deformity at skeletal maturity is expected in most patients. Observation and programmes of exercise are appropriate for mild, flexible, non-progressive deformities. Bracing is indicated for a moderate deformity which spans several levels and retains flexibility in motivated patients who have significant remaining spinal growth. The loss of some correction after the completion of bracing with recurrent anterior vertebral wedging has been reported in approximately one-third of patients. Surgical correction with instrumented spinal fusion is indicated for a severe kyphosis which carries a risk of progression beyond the end of growth causing cosmetic deformity, back pain and neurological complications. There is no consensus on the effectiveness of different techniques and types of instrumentation. Techniques include posterior-only and combined anteroposterior spinal fusion with or without posterior osteotomies across the apex of the deformity. Current instrumented techniques include hybrid and all-pedicle screw constructs.
Topics: Adolescent; Adult; Braces; Diagnosis, Differential; Humans; Middle Aged; Radiography; Scheuermann Disease; Spinal Fusion
PubMed: 21705553
DOI: 10.1302/0301-620X.93B7.26129