Effect of Surgery on Spinal Curves in Scheurermann's Disease

Patients with Scheuermann’s disease (SD) are the focus of this study. In SD there is an increased forward curve of the thoracic (mid to upper) spine. Forward curvature of the spine is called kyphosis. Too much or excessive forward curvature is called hyperkyphosis.

When the upper back curves forward the lower spine extends or bends backwards to keep the person upright. This position of the lumbar spine is called lumbar lordosis. The authors of this study asked two questions.

1) Is there a direct link between Scheuermann's kyphosis and lordosis? For example, if one curve increases, does the other curve increase, decrease, or stay the same?

2) If the kyphosis is corrected with surgery, is there a predictable change in the lumbar lordosis?

In this study, posterior fusion of the thoracic spine was done with metal rods on either side of the vertebra. Thirty (30) patients with SD were included. The results showed a definite connection between upper spine kyphosis and low back lordosis. The two were even more strongly linked after surgery than before.

The authors suggest the spine's dynamic system works to keep a balanced standing posture. Once the spine is no longer forced into forward flexion, the anatomy can get into a more normal or physiologic position. Most of the correction occurs in the upper lumbar spine.

Reference: 

Rob C. Jansen, MD, et al. Predictable Correction of the Unfused Lumbar Lordosis After Thoracic Correction and Fusion in Scheuermann Kyphosis. In Spine. May 15, 2006. Vol. 31. No. 11. Pp. 1227-1231.

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