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Journal of Manipulative and... 1996Two cases are discussed to illustrate two different presentations, progressions and treatments of Scheuermann's juvenile kyphosis.
OBJECTIVE
Two cases are discussed to illustrate two different presentations, progressions and treatments of Scheuermann's juvenile kyphosis.
CLINICAL FEATURES
In one case, a 13-yr-old boy suffered from a 2-yr history of lower back pain. Radiographs demonstrated irregularity of the upper lumbar vertebral endplates, associated with Schmorl's nodes. The second case is one of a 14-yr-old boy who was seen in an orthopedic outpatient clinic. Radiographs revealed wedging of the anterior border of T6, T7, and T8 vertebrae with a thoracic spine kyphotic deformity measuring 72 degrees.
INTERVENTION AND OUTCOME
The first case was treated conservatively. The patient maintained his improvement at 6 month follow-up. The second case was initially treated with a brace that the patient did not wear regularly as directed. The kyphotic deformity progressed from 72 degrees to 92 degrees. An operation was performed to reduce the kyphotic curve and prevent further progression. On review 6 yr later, the patient was well without back pain or other complications. The kyphotic curve measured 65 degrees.
CONCLUSION
Scheuermann's juvenile kyphosis is a common spinal deformity in the adolescent. A radiographic appearance of wedging of the anterior portion of the vertebral bodies with marked kyphotic deformity suggests the diagnosis of classical Scheuermann's disease. However, the lumbar type of Scheuermann's disease should be considered in young patient with radiographic evidence of irregular vertebral endplates, Schmorl's nodes and a decreased disc space without wedging. Nevertheless, significant progression of the curve in both the typical and atypical types of Scheuermann's disease is rare, but can occur. An algorithm is presented to facilitate decision making in the management of Scheuermann's juvenile kyphosis.
Topics: Adolescent; Algorithms; Braces; Chiropractic; Humans; Kyphosis; Male; Radiography; Scheuermann Disease
PubMed: 8728463
DOI: No ID Found -
The Journal of the American Academy of... Feb 2012Scheuermann kyphosis is a structural hyperkyphosis defined radiographically as anterior wedging of ≥5° of at least three consecutive vertebral bodies. Typically, the... (Review)
Review
Scheuermann kyphosis is a structural hyperkyphosis defined radiographically as anterior wedging of ≥5° of at least three consecutive vertebral bodies. Typically, the disease develops during adolescence but may not present until adulthood. The etiology remains unknown. Indications for management include progressive deformity, pain, cosmesis, neurologic deficit, and cardiopulmonary compromise. Surgical intervention is indicated in patients with persistent pain and unacceptable deformity caused by significant kyphosis. Surgery can be performed through posterior-only, anterior-only, or combined anterior-posterior approaches. Correction should include the entire length of the kyphosis and should not exceed 50% of the original deformity. The most common postoperative complications are wound infection and loss of correction.
Topics: Adult; Humans; Orthopedic Procedures; Radiography; Scheuermann Disease; Spine
PubMed: 22302449
DOI: 10.5435/JAAOS-20-02-113 -
Pain Research & Management 2021Scheuermann's kyphosis can cause severe back pain and cosmetic disorders to patients. Previous studies on surgical procedure selection for correction of Scheuermann's... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVES
Scheuermann's kyphosis can cause severe back pain and cosmetic disorders to patients. Previous studies on surgical procedure selection for correction of Scheuermann's kyphosis have drawn controversial conclusions. Here, a meta-analysis was performed to figure out a better way between anterior-posterior (AP) combined procedures and posterior-only (PO) procedures.
METHODS
We searched PubMed database and Ovid database, as well as Cochrane Library (between January 2009 and December 2020, around recent ten years), for studies reporting Scheuermann's kyphosis correction in an anterior way or a posterior way. Random effects meta-analysis regarding correction degrees and incidence of proximal junctional kyphosis (PJK) was performed.
RESULTS
Finally, 13 unique studies including 586 patients (AP: 300; PO: 286) were identified and included for this meta-analysis. Overall, 6 AP cohorts and 10 PO cohorts were pooled regarding the correction degrees of kyphosis in the analysis, respectively. Pooled correction degrees in AP cohorts were 33.31 (95% CI: 27.48-39.15; = 86%, < 0.001) and in PO cohorts were 31.16 (95% CI: 26.97-35.35; = 81.1%, < 0.001). Comparison of correction between AP and PO cohorts did not indicate any significant difference. Likewise, postoperative PJK incidence showed no difference. Back pain can be caused by both AP and PO procedures, but which causes less pain remains to be conclusive. The PO approach showed less blood loss and shorter surgical duration as compared to the AP approach.
CONCLUSIONS
In summary, this meta-analysis shows similar treatment effects between AP and PO procedures in correcting Scheuermann's kyphosis, suggesting the advantage of PO procedures due to less blood loss and surgical duration. However, the postoperative complications PJK and distal junctional kyphosis (DJK) cannot be well concluded due to the limitation of existing data.
Topics: Humans; Postoperative Complications; Scheuermann Disease; Spinal Fusion; Time Factors
PubMed: 34725561
DOI: 10.1155/2021/2142964 -
Archiv Fur Orthopadische Und... 1971
Topics: Adolescent; Age Factors; Germany; Humans; Japan; Scheuermann Disease; Scoliosis; Spinal Injuries; Spine
PubMed: 5116495
DOI: 10.1007/BF00417304 -
Acta Orthopaedica Et Traumatologica... May 2021This study aimed to investigate the possible relationship between Scheuermann disease (SD) and the pathophysiological factors of thoracic spinal stenosis (TSS),...
OBJECTIVE
This study aimed to investigate the possible relationship between Scheuermann disease (SD) and the pathophysiological factors of thoracic spinal stenosis (TSS), including ossification of the ligamentum flavum (OLF), ossification of the posterior longitudinal ligament (OPLL), and thoracic disc herniation (TDH) in patients with symptomatic TSS.
METHODS
Demographic and radiological data from 66 consecutive patients diagnosed with symptomatic TSS from 2013 to 2018 were retrospectively collected and divided into 3 groups depending on the underlying pathomechanism of TSS: TDH group (18 patients; 6 women; mean age ± standard deviation [Sd] = 59.89 ± 11.34), OPLL group (12 patients; 8 women; mean age ± Sd = 56.08 ± 14.74), and OLF group (36 patients; 20 women; mean age ± Sd = 58.69 ± 9.77). A total of 41 age-matched healthy individuals (19 women; mean age ± Sd = 54.88 ± 13.63) were designated as the control group. In each group, both typical and atypical SD criteria were radiologically examined. The demographic data and presence of SD between the control group and 3 subgroups of TSS pathomechanisms were evaluated.
RESULTS
SD characteristics were identified in 83.33% (15/18) of patients in the TDH group, 44.44% (16/36) in the OLF group, 25% (3/12) in the OPLL group, and 17.07% (7/41) of the control individuals. When analyzed by the chi-squared test and logistic regression analysis, the presence of SD was significantly associated with TDH (P < 0.01) and OLF (P < 0.05) but not OPLL (P > 0.05). Patients with TDH and OLF showed peak involvement of T10/11, and patients with OPLL did not. Furthermore, we determined that age, sex, body-mass index, and smoking status were not the risk factors for TDH, OPLL, and OLF (P > 0.05). SD was found to be a risk factor for TDH (P < 0.01) and OLF (P < 0.05) but not for OPLL (P > 0.05).
CONCLUSION
Evidence from this study indicated that SD might be a risk factor for OLF and TDH but not for OPLL.
Topics: Female; Humans; Male; Middle Aged; Ossification of Posterior Longitudinal Ligament; Radiography; Retrospective Studies; Risk Assessment; Risk Factors; Scheuermann Disease; Spinal Stenosis; Thoracic Vertebrae
PubMed: 34100367
DOI: 10.5152/j.aott.2021.20022 -
Journal of the College of Physicians... Jun 2020To verify whether Scheuermann's disease (SD) is a risk factor for patients with recurrent lumbar disc herniation (rLDH) than in patients without recurrence.
OBJECTIVE
To verify whether Scheuermann's disease (SD) is a risk factor for patients with recurrent lumbar disc herniation (rLDH) than in patients without recurrence.
STUDY DESIGN
Case-control study.
PLACE AND DURATION OF STUDY
Department of Orthopaedics, Yantaishan Hospital, China, from December 2016 to September 2019.
METHODOLOGY
The demographics (age, gender, body mass index [BMI], alcohol abuse, and current smoking), diabetes mellitus, and radiological data (affected levels, herniated side, herniation type, Pfirrmann grade, and the presence of SD) of 602 patients were retrospectively analysed, who underwent surgery for symptomatic LDH from December 2016 to August 2018. They were underwent one-year follow-up and were divided into LDH and rLDH groups. Both typical and atypical SD criteria were used to diagnose SD. Independent-sample t-test was used to analyse the role of age and BMI in both groups, and the Chi-square test was conducted to analyse other parameters. Logistic regression analysis was performed to evaluate various factors.
RESULTS
There was a significant difference in age (p=0.026), BMI (p=0.007), current smoking (p=0.001), and SD (p<0.001) between the groups. When these parameters were included in the logistic regression analysis, age, current smoking status, and SD were found to be risk factors for rLDH.
CONCLUSION
Age, current smoking, and SD are risk factors for rLDH. Older patients with radiological characteristics of SD should quit smoking to prevent rLDH. Key Words: Scheuermann's disease, Kyphosis, Disc herniation, Recurrence, Age, Smoking, Risk factor.
Topics: Case-Control Studies; China; Humans; Lumbar Vertebrae; Recurrence; Retrospective Studies; Risk Factors; Scheuermann Disease
PubMed: 32703341
DOI: 10.29271/jcpsp.2020.06.584 -
Spine Sep 2013Observational population-based study. (Observational Study)
Observational Study
STUDY DESIGN
Observational population-based study.
OBJECTIVE
To determine the prevalence of radiographical Scheuermann disease in a Dutch population and evaluate the consistency of diagnostic criteria.
SUMMARY OF BACKGROUND DATA
Scheuermann disease is a form of osteochondrosis characterized by increased posterior rounding of the thoracic spine with structural vertebral deformity. Different expert opinion-based radiological criteria exist, yet these have not been validated. The prevalence in the general population reported ranged from 1% to 10%.
METHODS
Lateral spine radiographs of 2753 Rotterdam Study participants (aged 45-89 yr) were assessed for Scheuermann disease using Sørensen and Sachs' radiographical criteria in 2 phases. Cohen κ statistics were calculated for interrater agreement. Prevalence estimates were calculated and sex differences were tested with Pearson χ test. We evaluated whether varying the kyphosis angle criterion would change the prevalence estimate.
RESULTS
A total of 677 (24.6%) individuals had endplate irregularities and 140 (5.1%) individuals had vertebral wedging. Abnormalities were significantly more prevalent among males (P < 0.05). The interrater agreement κ statistics were 78.8% for vertebral wedging and 79.4% for endplate irregularity. A total of 127 individuals had both criteria, of which 111 had a kyphosis angle greater than 45°, resulting in a prevalence of 4.0% (95% confidence interval [CI]: 3.3%-4.7%). The disease prevalence was 4.5% in males versus 3.6% in females, yet this difference was not statistically significant (P = 0.23). Adjustment of the kyphosis angle criterion from 45° to 40° or 35° increased the number of cases marginally, corresponding to prevalence estimates not significantly different from the estimates using original criteria (4.2% [95% CI: 3.3%-4.7%] and 4.4% [95% CI: 3.6%-5.2%]).
CONCLUSION
Our results revealed a prevalence of 4.0% of radiographical Scheuermann disease in Dutch individuals aged 45 years and older. Although there is no current "gold standard" for the radiographical definition, standardized scoring of independent features resulted in substantial interobserver agreement, and different applications of diagnostic criteria did not significantly alter the classification.
Topics: Aged; Aged, 80 and over; Cohort Studies; Female; Humans; Male; Middle Aged; Netherlands; Population Surveillance; Prevalence; Radiography; Scheuermann Disease
PubMed: 24509552
DOI: 10.1097/BRS.0b013e31829ee8b7 -
Der Orthopade Aug 2011Thoracic and thoracolumbar kyphosis is a common deformity in pediatric and adolescent populations. Kyphotic deformation of the spine is defined as a curve which shows an... (Review)
Review
Thoracic and thoracolumbar kyphosis is a common deformity in pediatric and adolescent populations. Kyphotic deformation of the spine is defined as a curve which shows an increase in the dorsal convex angulation. The most common causes of kyphosis in pediatric and adolescent populations are Scheuermann's disease, postural and congenital kyphosis. The fundamental principles of treatment are analysis of the kyphotic deformity and restoration or maintenance of sagittal balance. Clinically significant sagittal deformities can lead to severe pain, substantial cosmetic alterations, spinal cord dysfunction, problems with swallowing, gastrointestinal and cardiopulmonary complications. When the kyphotic deformity exceeds a certain point and conservative therapy options are no longer sufficient surgical intervention is indicated. The available operative options for treatment of the various types of pediatric and adolescent thoracolumbar kyphosis include dorsal instrumentation and fusion combined with ventral fusion and purely ventral instrumentation and fusion.
Topics: Adolescent; Biomechanical Phenomena; Child; Female; Humans; Kyphosis; Male; Osteotomy; Postural Balance; Radiography; Scheuermann Disease; Spinal Fusion; Young Adult
PubMed: 21725678
DOI: 10.1007/s00132-011-1799-1 -
Neurology Apr 2012
Topics: Adolescent; Humans; Magnetic Resonance Imaging; Male; Scheuermann Disease; Spinal Cord; Spinal Cord Compression; Thoracic Vertebrae
PubMed: 22508849
DOI: 10.1212/WNL.0b013e318250d87b -
Australian Family Physician Aug 1984English and Australian cricket teams on tour used to travel by ship, and many enjoying shipboard life, reached their destination considerably overweight and thus unfit...
English and Australian cricket teams on tour used to travel by ship, and many enjoying shipboard life, reached their destination considerably overweight and thus unfit and vulnerable to injury in their sport. Now they travel by air and most national teams employ a fitness coach to supervise sessions of rigorous exercise before and during the season. However the international cricket season is longer than it was and the incidence of overuse injuries is increasing.
Topics: Athletic Injuries; Extremities; Humans; Scheuermann Disease; Spondylolysis
PubMed: 6497768
DOI: No ID Found