Scheuermann’s Kyphosis: a 39-year follow-up from diagnosis in non-operated patients

Abstract

Purpose

To investigate the impact of Scheuermann’s Kyphosis (SK) on health -related quality of life (HRQOL) in adult patients and compare it to the general population. Moreover, to assess whether location of the kyphosis affects pelvic parameters, HRQOL, and pulmonary function.

Methods

Of a cohort of 251 patients seen for a pediatric spinal deformity in the years 1972–1982 in our outpatient clinic, 55 had radiologically verified SK. Thirty-eight participated in the study and responded to HRQOL questionnaires, 34 had radiographs taken and 31 had pulmonary function testing. The patients were divided into two groups according to location of the SK apex: thoracic (Th) above Th10 and thoracolumbar (TL) from Th10 and below. Spinopelvic parameters were measured for all radiographs. The HRQOL scores for all SK patients were compared with normative data from a Scandinavian population. Pulmonary function measurements were compared between the Th and TL SK groups.

Results

Mean follow-up was 39 ± 1.6 years, and mean age at follow-up was 53 ± 2.4 years. We found lower score in the TL group for SRS-22r function domain (p = 0.027) compared with the Th group, but no significant difference in the remaining domains and SRS-22r subscore (p > 0.18). The patients had significantly lower mean scores compared to normative values on SRS-22r domains pain (p = 0.049) and self-image (p = 0.006), but no statistically significant difference on SRS-22r subscore (p = 0.064). There was no difference in pelvic parameters between the two SK groups. We did not find a difference in pulmonary function on percent predicted FEV1 (FEV1%) (p = 0.91) and percent predicted FEV1/FVC (FEV1/FVC%) (p = 0.82) between the two SK groups.

Conclusion

We found a lower HRQOL in adult patients with SK 39 years after diagnosis regarding SRS-22r domains pain and self-image, and a tendency toward lower overall HRQOL compared with a background population. The location of the SK apex did not seem to have an overall impact on HRQOL. There was no difference in pelvic parameters in the two groups and no difference in pulmonary function.

Graphic abstract

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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by LR and CD. The first draft of the manuscript was written by LR, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Lærke Ragborg.

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The authors received grants from Medtronics and K2M, outside of the submitted work.

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Ragborg, L., Dragsted, C., Dahl, B. et al. Scheuermann’s Kyphosis: a 39-year follow-up from diagnosis in non-operated patients. Eur Spine J 29, 2091–2099 (2020). https://doi.org/10.1007/s00586-020-06384-w

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Keywords

  • Scheuermann disease
  • Kyphosis
  • HRQOL
  • Quality of life
  • SRS-22
  • Follow-up studies