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Poor Radiological and Good Functional Long-term Outcome of Surgically Treated Scheuermann Patients
Harm C A Graat1,2, Janneke J P Schimmel3, Roel J W Hoogendoorn1
1Department of orthopaedic surgery, Sint Maartenskliniek, Ubbergen, the Netherlands.
Spine
|December 19, 2015
Summary
Long-term outcomes for surgically treated Scheuermann kyphosis patients show disappointing radiological results but high patient satisfaction. Combined anterior-posterior surgery may yield better Oswestry Disability Index scores compared to posterior-only approaches.
Area of Science:
- Spine surgery
- Orthopedic surgery
- Pediatric orthopedics
Background:
- Long-term clinical and radiological outcomes of surgical Scheuermann kyphosis treatment remain largely unknown.
- A cohort study analyzed 33 consecutive patients surgically treated between 1991 and 1998.
- This study provides insights into the extended follow-up of this patient group.
Purpose of the Study:
- To evaluate the long-term clinical and radiological outcomes of surgically treated Scheuermann kyphosis.
- To assess patient-reported outcomes and identify factors influencing results.
- To compare different surgical approaches for Scheuermann kyphosis.
Main Methods:
- A cohort of 29 surgically treated Scheuermann patients (posterior approach: n=13; combined anterior-posterior: n=16) with a mean 18-year follow-up.
- Collection of Oswestry Disability Index (ODI) scores preoperatively and at two postoperative intervals (2-8 years and 14-21 years).
- Assessment of Visual Analog Scale (VAS) pain, Short Form-36 (SF-36), and EQ-5d scores at long-term follow-up, alongside radiographic analysis for complications.
Main Results:
- Mean kyphosis improved from 76° to 58°, with a median VAS pain of 2.5 and ODI of 12 at long-term follow-up.
- ODI scores improved significantly from preoperative to early and late postoperative periods; combined anterior-posterior approach showed better ODI than posterior-only.
- Proximal junctional kyphosis occurred in 53%, while 69% experienced implant failure/removal; radiological complications did not correlate with clinical outcomes, and 72% reported satisfaction.
Conclusions:
- Despite disappointing radiological findings, surgical treatment for Scheuermann kyphosis did not negatively impact long-term clinical outcomes or patient satisfaction.
- Lumbar pain did not preclude a high quality of life and patient satisfaction.
- A combined anterior-posterior surgical approach may be associated with superior functional outcomes compared to a posterior-only approach.
