PDA

View Full Version : Orthopaedic management of Scheuermann's


DublinPauline
19th April 2004, 03:30 PM
In case this is of interest, especially to you Mark...

The Orthopaedic management of Scheuermann's kyphosis

http://www.iol.ie/~rcsiorth/journal/volume5/issue1/sch.htm
Irish Journal of Orthopaedic Surgery and Trauma
Volume 5, Issue 1 2000


May be way out of date, of course.

Pauline

mark
30th October 2005, 11:15 PM
Orthopedic management of Scheuermann's (http://www.emedicine.com/orthoped/topic555.htm)

Very interesting document

mark

mark
30th October 2005, 11:25 PM
Bracing (http://www.srs.org/professionals/bracing_manuals/section12.pdf)

It it from the http://www.srs.org we bsite in the research paper section

http://www.srs.org/professionals

Grrrrrrrrrrr i hate the internet you can never do what you tell it to

mark
31st October 2005, 12:14 AM
If i can't manage to link it i may have upload it into the download section. Ignore me i'm just thinking aloud

mark

titch
31st October 2005, 11:30 AM
Just to let you know, the first link works fine for me, it is just that if you are not on broadband it may appear not to have worked immediately because it is a 2mb file, so will take several minutes to download.

mark
31st October 2005, 01:48 PM
Cool its working for me too today maybe i should have a little more patience and refrain from pushing buttons

enjoy the paper it's an interesting one

jamiebug44
12th November 2005, 08:54 AM
i have that

mark
12th November 2005, 10:12 AM
I thought you suffered from scoliosis jamie do you have a degree of kyphosis as well

jamiebug44
12th November 2005, 11:30 PM
is kyphasis scoliosis i am not sure?ihave 2 cruvers top lumber and bottom can't remeber

Jonny
12th November 2005, 11:35 PM
Kyphosis is where your back curves outwards too much. I don't think you have it Jamie :-)

mark
12th November 2005, 11:37 PM
Hello Jamie, i think if you had any degree of kyphosis your Dr would have told you

mark
29th November 2005, 07:53 PM
An Alternative Bracing Approach to Scheuermann's Disease: A Case Study
Miguel Gomez, MD
Patrick Flanagan, CO
Thomas Gavin, CO

ABSTRACT
Scheuermann's disease manifests itself as a thoracic or thoracolumbar kyphosis classically characterized by anterior wedging of 5 degrees or more of three adjacent thoracic vertebral bodies. Bracing has been shown to be effective in controlling a progressive curve in the adolescent patient. These adolescent patients typically present for medical attention because of pain or cosmetic deformity or both. Early treatment may be limited to observation and exercises, whereas patients who have kyphosis of up to 75 degrees and growth remaining may benefit from bracing. For the more common thoracic form with apices superior to T8, the Milwaukee brace's effectiveness has been documented and is usually the treatment of choice. This purpose of this article is to document a case for the treatment of the thoracic form of Scheuermann's disease (apice T6-7) with an underarm thoracolumbosacral orthosis. A custom thoracolumbosacral orthosis was measured and fabricated as an alternative to the Milwaukee brace to treat a 71-degree kyphosis with an apice of T6-T7. Initial in brace correction was 49%. At a fourteen-month follow-up, out-of-brace correction was maintained at 27% of the original kyphosis. These results indicate that a thoracolumbosacral orthosis may be a viable alternative to the Milwaukee brace in treating Scheuermann's disease with high apices


below is the link to the full study

here (http://www.oandp.org/jpo/library/2002_03_109.asp)


I DON'T LIKE THE CONSTANT REFERENCE TO DISEASE. SCHEUERMANN'S ISN'T SOMETHING YOU CATCH DOWN AT THE SWIMMING POOL

zerodegrees
30th November 2005, 04:29 PM
lets campaign to have it reclassified!

mark
30th November 2005, 10:53 PM
I think we need to John because i don't know about you but i don't feel diseased

mark
27th January 2006, 07:41 PM
Twenty-one patients with Scheuermann's kyphosis had surgery for progressive kyphotic deformity of 50[degrees] or greater. There were six adolescents, with a mean age of 15.6 years (range, 13-17 years) and 15 young adults, with a mean age of 25.4 years (range, 18-40 years). All patients had posterior spine arthrodesis with segmental compression instrumentation. Seven patients with rigid kyphosis had combined anterior and posterior spine arthrodesis. One patient died of superior mesenteric artery syndrome. In the group of 13 patients with posterior arthrodesis only, followup was 4.5 years. The mean preoperative thoracic kyphotic curve of 68.5[degrees] improved to 40[degrees] at latest review, with an average loss of correction of 5.75[degrees] . Junctional kyphosis occurred in two patients with a short arthrodesis: one at the cephalad end and one at the caudal end of the fused kyphotic curve. In the second group of seven patients with combined anterior and posterior arthrodesis, followup was 6 years. The mean preoperative thoracic kyphotic curve of 86.3[degrees] improved to 46.4[degrees] at latest review, with an average loss of correction of 4.4[degrees]. Overall, there was no postoperative neurologic deficit and no pseudarthrosis. Thus, posterior arthrodesis and segmental compression instrumentation seems to be effective for correcting and stabilizing kyphotic deformity in Scheuermann's disease. Despite a long operating time, this technique provided significant correction, avoiding the development of any secondary deformity in most patients. Combined anterior and posterior spine arthrodesis is recommended for rigid, more severe kyphotic deformities.

mark
27th January 2006, 07:51 PM
Study Design. A historic cohort study was conducted to investigate surgical correction and sagittal alignment in 33 patients with thoracic Scheuermann's disease.

Objective. To evaluate kyphosis correction, correction loss, sagittal balance, and the effect of an anterior release.

Summary of Background Data. Currently, both posterior and anteroposterior techniques seem to produce impressive corrections for Scheuermann's disease. However, few reports have been made on sagittal malalignment after surgery.

Methods. A cohort of 33 patients who had undergone surgery for their Scheuermann's kyphosis were reviewed: Group A: posterior technique (n = 16), Group B: anteroposterior technique (n = 17). Pre- and postoperative curve morphometry (Cobb, Ferguson, Voutsinas), balance (C7 plumb line), and Oswestry score were compared.

Results. The mean follow-up period was 4.5 +/- 2 years (range, 2-8.2 years). The mean preoperative kyphosis (Cobb) was 78.7[degrees] +/- 8.9[degrees], and the mean postoperative kyphosis was 51.7[degrees] +/- 10.3[degrees]. At follow-up evaluation, the correction loss was 1,4[degrees] +/- 3.9[degrees]. There was no difference in curve morphometry, correction, sagittal balance, average age, and follow-up period between Groups A and B. One junctional kyphosis, in Group B, was noted. After surgery, all the patients were satisfied, and the Oswestry score showed significant improvement. No neurologic complications were observed.

Conclusions. Good follow-up results included a 100% follow-up rate, adequate corrections, little correction loss, lower Oswestry scores, and a high satisfaction rate in both groups. The anteroposterior treatment did not influence the curve morphometry more than posterior fusion only. In reducing postoperative sagittal malalignment, the authors believe that surgical management should aim at a correction within the high normal kyphosis range of 40[degrees] to 50[degrees], consequently providing good results and, particularly in flexible adolescents and young adults, minimizing the necessity for an anterior release.

mark
27th January 2006, 07:55 PM
Abstract. The aim of this prospective study was to evaluate radiographic findings, patient satisfaction and clinical outcome, and to report complications and instrumentation failure after operative treatment of Scheuermann's disease using a combined anterior and posterior spondylodesis. The loss of sagittal plane correction after removal of the posterior instrumentation was analysed. The indication for surgery was a thoracic kyphosis greater than 60 in adolescents and adults with persistent back pain, which failed to respond to conservative treatment. Thoracic kyphosis and lumbar lordosis angles were measured by the Cobb method at preselected time points and at final follow-up. Sagittal plane alignment was measured as translation. The validated Scoliosis Research Society Instrument (SRSI) questionnaire was sent to all patients at follow-up. P-values were calculated using the Wilcoxon signed rank test (P<0.05 is significant). Between October 1987 and August 1999, 23 consecutive patients underwent operative treatment. The median follow-up was 75 months (range 25-126 months). Median preoperative thoracic kyphosis was 70 (range 62-78) and median preoperative lumbar lordosis was 68 (range 54-84). Immediate postoperative median thoracic kyphosis was 39 (range 28-54) (P<0.05) and immediate postoperative median lumbar lordosis was 49 (range 35-63) (P<0.05). These significant corrections were maintained at early follow-ups conducted 1 year and 2 years postoperatively. At final follow-up, the median thoracic kyphosis had significantly increased, to 55 (range 36-65) (P<0.05 relative to immediate postoperative value), and the median lumbar lordosis had increased to 57 (range 44-70) (P<0.05). The late deterioration of correction in the sagittal plane was mainly caused by removal of the posterior instrumentation, and occurred despite radiographs, bone scans and thorough intra-operative explorations demonstrating solid fusions. The median SRSI score was 83 points (range 55-106). There was no significant correlation between the radiographic outcome and the SRSI score (P>0.05). Our series showed relatively fair outcome after operative treatment in Scheuermann's disease. Therefore, the indication for surgery in patients with Scheuermann's disease can be questioned.

mark
9th February 2006, 07:30 PM
http://www.cpsp.edu.pk/jcpsp/ARCHIEVE/Sep2005/Article17.pdf

NEUROLOGIC COMPRESSION BY THORACIC DISC IN A
CASE OF SCHEUERMANN KYPHOSIS - AN INFREQUENT
COMBINATION

Little Ali
10th February 2006, 02:09 PM
Thanks Mark! That's what I'm having problems with at the moment and it's flippin killing me!

mark
10th February 2006, 07:13 PM
Hi Ali

I'm glad you found it useful sometimes you put things up and you wonder if its of any use thanks for the feed back
Hope the pain is a little easier

Take care

Mark

mark
1st March 2006, 10:37 PM
All the Scheuermann's links gathered together for easy reference

mark
10th March 2006, 11:26 PM
Please feel free to add any articles or useful websites

Thanks

Mark

mark
30th March 2006, 10:07 PM
http://www.srs.org/professionals/resources...ns_kyphosis.pdf (http://www.srs.org/professionals/resources/scheuermanns_kyphosis.pdf)

Another interesting article. However the use of the term hunchback in a proffesional paper does make me wince

mark
25th March 2007, 10:50 PM
http://www.spine-surgery.com/53_261_303946...34238454236.htm (http://www.spine-surgery.com/53_261_3039464130443630463841303435463639453343353 844343033434238454236.htm)

Seeking_help
27th June 2007, 09:47 PM
Since there hasn't been much activity in the kyphosis forum, I thought I'd add some links I've come across while researching treatments. Most of these revolve around spinal fusion.

Spinal Fusion - General Information
http://www.spine.org/articles/spinalfusion.cfm
http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=156
http://orthopedics.about.com/od/spinalsurgery/a/fusion.htm
http://adam.about.com/encyclopedia/Spinal-fusion.htm

Spinal Fusion - Lumber Fusion
http://www.spine-health.com/topics/surg/ov...bar/lumb05.html (http://www.spine-health.com/topics/surg/overview/lumbar/lumb05.html)

I'll post some more later.

Seeking_help
27th June 2007, 11:47 PM
Additional links:

Spinal Fusion - General Information
http://www.backrack.co.uk/fusion.shtml
http://www.lajollaspine.com/stfu_ant_thor.shtml
http://www.lajollaspine.com/stfu_post_thor.shtml
http://www.umm.edu/ency/article/002968.htm
https://www.fhshealth.org/medSurg_proced/spinalFusion.asp

chicago
28th May 2011, 05:27 PM
I DON'T LIKE THE CONSTANT REFERENCE TO DISEASE. SCHEUERMANN'S ISN'T SOMETHING YOU CATCH DOWN AT THE SWIMMING POOL

ya calling it a disease it a little extreme

rbmiles
16th March 2012, 04:25 AM
when i was at ft. knox all my buddies jokingly called me the hunchback of ft. knox. Not going to lie it kinda pissed me off haha. I got discharged for it but again, nobody was able to tell me exactly what I had. There arent very many things that piss me off either.

AliciaOConnor
20th March 2012, 04:35 PM
I am new here and learning quite a bit very fast. So far from reading a ton of information and talking with many people who have had spinal fusion, there hasn't seemed to be to much of a downside. (well besides recovery) Am I correct on this?

My son is 10 and will be 11 in June. He has Kyphosis and scoliosis. His spinal curving is progressing faster than anyone expected and surgery has been brought to the table or bracing him for 6 years and then still possibly needing surgery.