Scheuermann's Kyphosis: Diagnosis, Management, and Selecting Fusion Levels
Overview
Orthopedics
Affiliations
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.
Surgical treatment algorithm for thoracic and lumbar hyperkyphosis in pediatric population.
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PMID: 39432190 DOI: 10.1007/s43390-024-00986-w.
Bipolar hybrid posterior instrumentation tecnique for the correction of Scheuermann's kyphosis.
Solans Lopez M, Hernandez Mateo J, Barrios Ayuso A, Igualada Blazquez C, Quevedo Narciso T, Garcia Martin A Spine Deform. 2024; 12(6):1751-1759.
PMID: 39026125 DOI: 10.1007/s43390-024-00928-6.
Vitamin D deficiency in Scheuermann's disease is associated with increased adverse outcomes.
Chokshi S, Mudiganty S, Clement 3rd R, Accousti W SICOT J. 2024; 10:13.
PMID: 38568088 PMC: 10989516. DOI: 10.1051/sicotj/2024010.
A Novel Surgical Indication for Scheuermann's Kyphosis.
Haselhuhn J, Odland K, Soriano P, Jones K, Polly Jr D J Am Acad Orthop Surg Glob Res Rev. 2024; 8(3).
PMID: 38441155 PMC: 10914238. DOI: 10.5435/JAAOSGlobal-D-23-00187.
Distal Junctional Failures in Degenerative Thoracolumbar Hyperkyphosis.
Wang Y, Li J, Xi Y, Zeng Y, Yu M, Sun Z Orthop Surg. 2024; 16(4):830-841.
PMID: 38384146 PMC: 10984817. DOI: 10.1111/os.13973.