• Harm C A Graat, Janneke J P Schimmel, Roel J W Hoogendoorn, Lotte van Hessem, Allard Hosman, and Marinus de Kleuver.
• *Department of orthopaedic surgery, Sint Maartenskliniek, Ubbergen, the Netherlands †Department of orthopaedic surgery, Medisch Centrum Alkmaar, The Netherlands ‡Department of Research, Sint Maartenskliniek, Ubbergen, The Netherlands §Department of orthopaedic surgery, University Medical Center Nijmegen, Nijmegen, The Netherlands ¶Department of orthopaedic surgery, VU University Medical Center, Amsterdam, The Netherlands.
• Spine. 2016 Jul 15; 41 (14): E869-78.

Study DesignCohort study.ObjectiveTo analyze long-term clinical and radiological outcomes of surgically treated Scheuermann patients.Summary Of Background DataLong-term clinical and radiological outcomes of surgery for Scheuermann kyphosis are unknown. A single-center cohort of 33 consecutive, surgically treated (between 1991 and 1998) Scheuermann patients was studied.MethodsClinical and radiological data of 29 surgically treated Scheuermann patients were collected (posterior approach n = 13; combined anterior-posterior procedure n = 16), after a mean follow-up of 18 years. Oswestry Disability Index (ODI) scores were measured preoperatively (PRE) and twice postoperatively: 2 to 8 years postoperative (FU 1) and 14 to 21 years postoperative (FU 2). Visual Analog Score pain, Short Form-36 (SF-36), and EQ-5d scores were recorded at FU 2 only. Radiographs were analyzed for correction, distal and proximal junctional kyphosis, and implant failures.ResultsMean preoperative kyphosis of the corrected levels was 76° (range 60°-105°) and decreased to a Cobb of 58°(range 30°-105°) at FU 2. Median Visual Analog Score was 2.5 points (range 0-8) and median ODI score was 12 (range 0-62) at FU 2. The ODI score at FU 1 was significantly better as compared to PRE (P < 0.001) and FU 2 (P < 0.001). Also, anterior-posterior treated group had a significantly better ODI score as compared to the posterior-only group (P = 0.023). EQ-5d scores on mobility, usual activities, and pain/discomfort were worse compared to an age-matched population control group; however, SF-36 outcome scores were comparable.Proximal junctional kyphosis was present in 53% of patients, distal junctional kyphosis did not occur, and implant failure/removal had occurred in 69% of patients. Radiological complications do not relate with the ODI, EQ-5d, and SF-36 and 72% of the patients were satisfied.ConclusionRadiological results of this cohort were disappointing but did not relate to clinical outcome scores. Even lumbar pain could not prevent a high patient satisfaction and quality of life. Patients treated with a combined anterior-posterior approach tended to perform better.Level Of Evidence3.

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