• Baron Lonner, Andrew Yoo, Jamie S Terran, Paul Sponseller, Amer Samdani, Randy Betz, Harry Shuffelbarger, Suken A Shah, and Peter Newton.
• *Hospital for Joint Diseases-NYU Medical Center, New York, NY †Johns Hopkins Hospital, Baltimore, MD ‡Shriners Hospital for Children, Philadelphia, PA §Miami Children's Hospital, Miami, FL ¶Nemours Children's Clinic, Wilmington, DE; and ‖Rady Children's Hospital, San Diego, CA.
• Spine. 2013 May 20;38(12):1049-55.

Study DesignA prospective multicenter study and retrospective chart review.ObjectiveTo compare health-related quality of life (HRQOL) measures and sagittal deformity in operative Scheuermann kyphosis (SK), operative adolescent idiopathic scoliosis (AIS), and normal populations.Summary Of Background DataNo study to date has evaluated patient reported HRQOL measures before surgery in operative patients with SK.MethodsHRQOL data were prospectively collected pretreatment for operative patients with SK using the SRS-22 outcomes instrument and visual analogue scale (VAS). Comparison was made with the SRS-22 from operative AIS and normal populations. Eighty-six patients with SK enrolled in the prospective study were compared with 184 patients with AIS from a prospective database and 31 normal controls. To study the correlation between T5-T12 kyphosis magnitude and SRS-22 score, patients with AIS and SK were pooled together to create a larger continuum of kyphosis. Analysis of covariance, Pearson correlation analysis, and Bonferroni pairwise comparisons were used to determine statistical differences between group demographics, HRQOL indicators, and radiographical variables.ResultsPatients with SK had significantly lower scores in all domains of the SRS-22 than patients with AIS. Patients with SK with a thoracolumbar apex reported significantly lower mean scores in the pain domain than those with a thoracic apex. Significant negative correlations were found between all domains of the SRS-22 and T5-T12 kyphosis-the self-image domain demonstrated the highest correlation (r = 0.37). VAS score in the SK population correlated negatively to the pain, self-image, and mental health domains.ConclusionIncreasing sagittal plane deformity as a result of SK has a significant impact on HRQOL as determined by the SRS-22 outcome instrument. In this study, patients with SK reported significantly decreased (worse) scores in all subdomains of the SRS-22 compared with patients with AIS.Level Of Evidence1.

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