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Comparing surface topographic range of motion in pediatric patients with Scheuermann kyphosis to healthy controls
Jenna L Wisch1, Akshitha Adhiyaman1, Ankush Thakur1
1Hospital for Special Surgery, New York, NY, 10021, USA.
Purpose:
This study compares the range of motion (ROM) in all three planes in patients with Scheuermann kyphosis (SK) to healthy controls using surface topographic (ST) scanning.
Methods:
SK patients and healthy controls between 11-21 years old were recruited prospectively. Patients underwent ST scanning in maximal forward bend, twist to the right and left, and side-bend to the right and left. Sagittal, axial, and coronal ROM were computed using an automated pathway. An analysis of variance was used to determine significant differences in the ROM (coronal, axial, and sagittal) and asymmetry (coronal and axial) of SK patients versus controls. Scoliosis Research Society (SRS) 22r total, self-image, pain and function, as well as Patient-Reported Outcome Measurement Information System (PROMIS) mobility, physical activity and pain interference scores, and HSS Pedi-FABS were collected for all patients.
Results:
23 patients with SK and 98 controls were analyzed. SK group was 78.3% male with BMI of 24.1 kg/m2, average thoracic kyphosis angle of 75.0°. Control group was 55.1% male with a BMI 20.9 kg/m2. Compared to controls, patients with SK had 18.0° less sagittal, 12.0° less coronal ROM, and 15.5° less axial ROM. Controlling for age, sex, BMI, HSS Pedi-FABS did not change significance except for axial asymmetry index when controlling for sex. Patients with SK had lower SRS22r pain scores (4.1 vs. 4.4, p = 0.023), SRS22r self-image scores (3.5 vs. 4.5, p < 0.001) and SRS22r total scores (3.9 vs. 4.4, p < 0.001) compared to controls.
Conclusions:
Patients with SK have reduced ROM in all three planes measured by ST, compared to controls. The restriction in motion is accompanied by lower SRS22r pain and total scores, indicating that motion may play an important role in a patient's quality of life. This study is limited by the lack of evaluation of extension when assessing sagittal range of motion, which has previously been documented to be compromised by SK.
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