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Scheuermann's Disease Revisited

Posted on: 12/24/2002
If you were going to have major back surgery, wouldn't you want to know what the result might be down the road? Patients with Scheuermann's disease may be in for some new information on this.

Scheuermann's disease is a forward curvature of the spine caused by wedging of three or more vertebrae. The excess forward bend is called kyphoscoliosis. The middle part of the back is affected the most, but the spine above and below the curve changes too.

Surgery to correct the curve is the most common treatment when the curve is severe and the back is painful. Doctors are studying when to do the surgery. Some doctors think the earlier, the better.

A recent study from the Netherlands has some new information about this. Based on their results with 23 cases, these doctors suggest that surgery for Scheuermann's disease should only be done on adults. The curve should be more than 75 degrees (normal is between 20 and 40 degrees). The patient must have pain that doesn't go away with other medical treatment.

These researchers also found that once the spine is fused, the hardware shouldn't be removed. Metal plates, rods, and screws are used to hold the spine upright until the bone fuses solidly. When these are removed, the spine loses the correction and collapses. This happens even in patients with solid bone fusion.

Correction of a kyphoscoliosis for Scheuermann's disease can have good results. The spine can keep its correction so long as the support implants stay in place. If the hardware pushes out and causes pain, it can be revised. The authors of this study think this is a better option than removal.

R. W. Poolman, et al. Clinical Outcome and Radiographic Results After Operative Treatment of Scheuermann's Disease. In European Spine Journal. December 2002. Vol. 11. No. 6. Pp. 561-569.

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