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Body Mass Index in Adolescent Spinal Deformity: Comparison of Scheuermann’s Kyphosis, Adolescent Idiopathic Scoliosis, and Normal Controls

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Abstract

Study Design

Prospective, multicenter study of Scheuermann’s kyphosis (SK) and adolescent idiopathic scoliosis (AIS) compared to a control group.

Objectives

Compare body mass index (BMI) and Scoliosis Research Society Questionnairee22 (SRS-22) scores among two diagnosis and one control group.

Summary of Background Data

BMI has been reported as increased in SK patients; however, there are few recent data on this subject or comparing SK to AIS.

Methods

Ninety-two SK patients (37 female, 55 male, average age 16 years), 1,051 AIS patients (814 female, 237 male, average age 15 years), and 380 adolescents without scoliosis (controls) were compared based on age, gender, race, height (m), weight (kg), BMI, and SRS-22 scores. An analysis of variance was used to test differences in BMI and SRS-22 scores between the groups and between males and females. Pearson correlations determined the relationship between AIS T5eT12 kyphosis and BMI, SK max kyphosis and BMI, and to determine the relationship between BMI and SRS-22 scores in each group.

Results

More SK patients were “obese” and “overweight” (28% and 22%) compared to the AIS (6% and 9%) and Control groups (5.8% and 17.9%) (p <.001). More AIS patients were “underweight” (27%, SK: 13%, Control: 12.1%; p <.03). T5eT12 kyphosis was weakly correlated with BMI (r = 0.17), whereas max kyphosis correlated well with BMI (r 5 0.39, p<.00). The SK group had significantly lower (worse) SRS-22 scores than AIS patients in the Pain (3.97 vs. 4.10), Self-Image (2.86 vs. 3.35), Mental Health (3.72 vs. 4.02), and Total Score domains (3.62 vs. 3.92, p <.001). Increased pain scores were weakly correlated with decreasing BMI in all three groups.

Conclusions

SK patients are at increased risk for elevated BMI and worse SRS-22 scores, indicating that they may suffer from delayed diagnosis and increased surgical complications. AIS patients are at increased risk for issues related to low BMI and should also be monitored.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Beth Israel Medical Center, New York, NY, 10003, USA

    Baron S. Lonner MD

  2. Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY, 10003, USA

    Courtney S. Toombs & Qasim M. Husain MD

  3. Department of Orthopaedic Surgery, Johns Hopkins Hospital, Baltimore, MD, 21287, USA

    Paul Sponseller MD

  4. Department of Orthopaedic Surgery, Miami Children’s Hospital, Miami, FL, 33155, USA

    Harry Shufflebarger MD

  5. Department of Orthopaedic Surgery, Nemours Children’s Clinic, Wilmington, DE, 19803, USA

    Suken A. Shah MD

  6. Department of Orthopaedic Surgery, Shriners Hospitals for Children, Philadelphia, PA, 19140, USA

    Amer F. Samdani MD, Randal R. Betz MD & Patrick J. Cahill MD

  7. Department of Orthopaedic Surgery, Rady Children’s Hospital San Diego, San Diego, CA, 92123, USA

    Burt Yaszay MD & Peter O. Newton MD

Authors
  1. Baron S. Lonner MD
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  2. Courtney S. Toombs
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  3. Qasim M. Husain MD
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  4. Paul Sponseller MD
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  7. Amer F. Samdani MD
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  11. Peter O. Newton MD
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Corresponding author

Correspondence to Baron S. Lonner MD.

Additional information

Author disclosures: BSL (grants from Setting Scoliosis Straight Foundation [Depuy Spine, 2006DEF13], during the conduct of the study; grants from AOSpine, grants from John & Marcela Fox Fund, grants from OREF, personal fees from Depuy Spine, personal fees from Paradigm Spine, personal fees from Spine Search, personal fees from K2M, outside the submitted work); CST (none); OMH (none); PS (none); HS (Miami Children’s Hospital was paid for data collection by Harms Study Group; receives royalties from DePuy Spine, is a consultant for DePuy Spine, and is on the speaking panel of DePuy Spine); SAS (grants from Setting Scoliosis Straight Foundation, during the conduct of the study; grants from Setting Scoliosis Straight Foundation, personal fees from DePuy Synthes Spine, outside the submitted work); AFS (personal fees from DePuy Synthes Spine, personal fees from SpineGuard, personal fees from Zimmer, personal fees from Stryker, outside the submitted work); RRB (grants and nonfinancial support from DePuy Synthes Spine, during the conduct of the study; grants and personal fees from DePuy Synthes Spine, grants and personal fees from Medtronic, personal fees from Orthocon, personal fees from SpineGuard, personal fees from Orthobond, personal fees from MiMedx, outside the submitted work); PJC (grants and personal fees from DePuy Synthes Spine, grants and personal fees from Medtronic, outside the submitted work); BY (grants, personal fees, and nonfinancial support from Depuy Synthes, grants, personal fees, nonfinancial support and other from K2M, personal fees from Medtronic, other from Orthopaediatrics, outside the submitted work); PON (grants from Setting Scoliosis Staight Foundation, during the conduct of the study; grants and other from POSNA, grants and other from Setting Scoliosis Straight Foundation, grants and other from SRS, personal fees and other from Children’s Specialists of San Diego, other from Children’s Specialists Foundation, grants and personal fees from DePuy Synthes Spine, personal fees from Stanford University, personal fees from Norcal, personal fees from Law firm of Carroll, Kelly, Trotter, Franzen & McKenna, personal fees from Law firm of Smith, haughey, Rice & Roegge, grants from NIH, grants from OREF, grants from Axial Biotech, grants from Biospace Med/EOS Imaging, and personal fees from Nuvasive, outside the submitted work).

Funding: Grant from DePuy Spine to Setting Scoliosis Straight Foundation in support of the Harms Study Group’s research.

IRB approval: Institutional review board approval was obtained for this study from the NYU Langone Medical Center IRB.

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Lonner, B.S., Toombs, C.S., Husain, Q.M. et al. Body Mass Index in Adolescent Spinal Deformity: Comparison of Scheuermann’s Kyphosis, Adolescent Idiopathic Scoliosis, and Normal Controls. Spine Deform 3, 318–326 (2015). https://doi.org/10.1016/j.jspd.2015.02.004

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  • DOI: https://doi.org/10.1016/j.jspd.2015.02.004

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