Posterior instrumented correction and fusion of Scheuermann´s results in physiological reconstruction of sagittal alignment and excellent overall clinical outcome- clinical trail of 73 patients

Abstract Purpose The aim was to assess the clinical outcomes after posterior spinal fusion (PSF) in patients with Scheuermann’s disease (SD). Methods SD undergoing PSF were retrospectively analyzed. Clinical outcome was determined using SRS-22- and Eq. 5D-questionaires preop and after 3, 12, 24 mont...

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Main Authors: M.-L. Jensch, U. Platz, M. Quante, M. Köszegvary, B. Thomsen, J. Gliemroth, C. Berlin, H. Halm
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Musculoskeletal Disorders
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Online Access:https://doi.org/10.1186/s12891-024-08205-3
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author M.-L. Jensch
U. Platz
M. Quante
M. Köszegvary
B. Thomsen
J. Gliemroth
C. Berlin
H. Halm
author_facet M.-L. Jensch
U. Platz
M. Quante
M. Köszegvary
B. Thomsen
J. Gliemroth
C. Berlin
H. Halm
author_sort M.-L. Jensch
collection DOAJ
description Abstract Purpose The aim was to assess the clinical outcomes after posterior spinal fusion (PSF) in patients with Scheuermann’s disease (SD). Methods SD undergoing PSF were retrospectively analyzed. Clinical outcome was determined using SRS-22- and Eq. 5D-questionaires preop and after 3, 12, 24 months after surgery. Whole spine x-rays were analyzed (preop, postop, after 6, 12, 24 months): sagittal and coronary Cobb angles, and pelvic parameters were evaluated; ideal lumbar lordosis (LL) was calculated using formula of le Huec (LL = 0.54*PI + 27.6). Surgical time, complications and blood loss were compared. Postop appearance of proximal (PJF) and distal junction failure (DJF) were calculated. Values were given as mean. Comparison with significance α = 0.05. Results 73 patients were included. SRS-22 total score and EQ5D showed significant increase from preop to two-year FU (each p < 0.001). Preop Thoracic kyphosis (TK) was 75.1° with significant correction to 48.5° (p < 0.001). LL showed mean correction from 68.2° to 46.7° (p < 0.001). Difference between ideal and measured LL showed improvement from − 17.2° preop to -3.3° 6 month postop, good spontaneous correction of hyperlordosis. 63% had < 10° deviation from ideal LL 6 month postoperatively, whereas only 21.4% were in this range preoperatively. No significant changes for spinopelvic parameters during FU. Complications occurred in 13,7% of cases. A low revision rate for PJF (2,7%) was necessary. Subscore mental health showed a correlation to preop TK (p < 0.05). Conclusion Physiological reconstruction of sagittal alignment could be achieved in most cases (63%). Clinical FU results were convincing with significant improvement of patient’s satisfaction. Complication rate was moderate and risk of PJF after PSF low.
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spelling doaj-art-3f6184af119845f8bf67f8eab3e4b8da2025-02-02T12:05:29ZengBMCBMC Musculoskeletal Disorders1471-24742025-01-012611910.1186/s12891-024-08205-3Posterior instrumented correction and fusion of Scheuermann´s results in physiological reconstruction of sagittal alignment and excellent overall clinical outcome- clinical trail of 73 patientsM.-L. Jensch0U. Platz1M. Quante2M. Köszegvary3B. Thomsen4J. Gliemroth5C. Berlin6H. Halm7Department of Neurosurgery, University Hospital Schleswig- HolsteinDepartment of Spine Surgery, University Hospital Carl Gustav CarusDepartment of Spine Surgery, Ameos Clinic EutinDepartment of Spine Surgery, Ameos Clinic EutinDepartment of Spine Surgery, Ameos Clinic EutinDepartment of Neurosurgery, University Hospital Schleswig- HolsteinDepartment of Spine Surgery, Ameos Clinic EutinDepartment of Spine Surgery, Ameos Clinic EutinAbstract Purpose The aim was to assess the clinical outcomes after posterior spinal fusion (PSF) in patients with Scheuermann’s disease (SD). Methods SD undergoing PSF were retrospectively analyzed. Clinical outcome was determined using SRS-22- and Eq. 5D-questionaires preop and after 3, 12, 24 months after surgery. Whole spine x-rays were analyzed (preop, postop, after 6, 12, 24 months): sagittal and coronary Cobb angles, and pelvic parameters were evaluated; ideal lumbar lordosis (LL) was calculated using formula of le Huec (LL = 0.54*PI + 27.6). Surgical time, complications and blood loss were compared. Postop appearance of proximal (PJF) and distal junction failure (DJF) were calculated. Values were given as mean. Comparison with significance α = 0.05. Results 73 patients were included. SRS-22 total score and EQ5D showed significant increase from preop to two-year FU (each p < 0.001). Preop Thoracic kyphosis (TK) was 75.1° with significant correction to 48.5° (p < 0.001). LL showed mean correction from 68.2° to 46.7° (p < 0.001). Difference between ideal and measured LL showed improvement from − 17.2° preop to -3.3° 6 month postop, good spontaneous correction of hyperlordosis. 63% had < 10° deviation from ideal LL 6 month postoperatively, whereas only 21.4% were in this range preoperatively. No significant changes for spinopelvic parameters during FU. Complications occurred in 13,7% of cases. A low revision rate for PJF (2,7%) was necessary. Subscore mental health showed a correlation to preop TK (p < 0.05). Conclusion Physiological reconstruction of sagittal alignment could be achieved in most cases (63%). Clinical FU results were convincing with significant improvement of patient’s satisfaction. Complication rate was moderate and risk of PJF after PSF low.https://doi.org/10.1186/s12891-024-08205-3Scheuermann’s diseaseHyperkyphosisSRS- 22Equation 5DPSF
spellingShingle M.-L. Jensch
U. Platz
M. Quante
M. Köszegvary
B. Thomsen
J. Gliemroth
C. Berlin
H. Halm
Posterior instrumented correction and fusion of Scheuermann´s results in physiological reconstruction of sagittal alignment and excellent overall clinical outcome- clinical trail of 73 patients
BMC Musculoskeletal Disorders
Scheuermann’s disease
Hyperkyphosis
SRS- 22
Equation 5D
PSF
title Posterior instrumented correction and fusion of Scheuermann´s results in physiological reconstruction of sagittal alignment and excellent overall clinical outcome- clinical trail of 73 patients
title_full Posterior instrumented correction and fusion of Scheuermann´s results in physiological reconstruction of sagittal alignment and excellent overall clinical outcome- clinical trail of 73 patients
title_fullStr Posterior instrumented correction and fusion of Scheuermann´s results in physiological reconstruction of sagittal alignment and excellent overall clinical outcome- clinical trail of 73 patients
title_full_unstemmed Posterior instrumented correction and fusion of Scheuermann´s results in physiological reconstruction of sagittal alignment and excellent overall clinical outcome- clinical trail of 73 patients
title_short Posterior instrumented correction and fusion of Scheuermann´s results in physiological reconstruction of sagittal alignment and excellent overall clinical outcome- clinical trail of 73 patients
title_sort posterior instrumented correction and fusion of scheuermann´s results in physiological reconstruction of sagittal alignment and excellent overall clinical outcome clinical trail of 73 patients
topic Scheuermann’s disease
Hyperkyphosis
SRS- 22
Equation 5D
PSF
url https://doi.org/10.1186/s12891-024-08205-3
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