Related Experiment Videos
Scheuermann's Kyphosis: Diagnosis, Management, and Selecting Fusion Levels
Zeeshan M Sardar1, Robert J Ames, Lawrence Lenke
1From the Department of Orthopedic Surgery, Columbia University College of Physicians and Surgeons, New York, NY (Dr. Sardar and Dr. Lenke), and the Department of Orthopaedic Surgery and Sports Medicine, Lewis Katz School of Medicine, Temple University, Philadelphia, PA (Dr. Ames).
Abstract:
Scheuermann's kyphosis (SK) is a rigid structural deformity of the thoracic spine defined radiographically as three or more contiguous vertebrae with at least 5° of wedging anteriorly. Prevalence of the disease is thought to be between 0.4% and 10%. The true cause of SK remains unclear; however, various theories include growth irregularities, mechanical factors, genetic factors, and/or poor bone quality as the causes. Patients with mild disease (less than 70°) generally have a favorable prognosis with good clinical outcomes. Most patients with SK are successfully treated nonsurgically with observation, anti-inflammatory medications, and physical therapy. Surgical intervention is indicated in patients with greater than 70° to 75° thoracic curves, greater than 25° to 30° thoracolumbar curves, intractable pain, neurologic deficit, cardiopulmonary compromise, or poor cosmesis. Because of advances in posterior spinal instrumentation, surgery can typically be performed through a posterior-only approach. When surgical treatment is planned, appropriate selection of the upper- and lower-instrumented vertebrae is important to achieve a well-balanced spine, preserve motion segments, and reduce the risk of junctional kyphosis.