gms | German Medical Science

54. Jahrestagung der Norddeutschen Orthopädenvereinigung e. V.

Norddeutsche Orthopädenvereinigung

16.06. bis 18.06.2005, Hamburg

Conservative treatment of Scheuermann kyphosis

Meeting Abstract

  • corresponding author M. Schneider - Klinik und Poliklinik für Allgemeine Orthopädie, Münster
  • R. Toth - Münster
  • T. Lerner - Münster
  • U. Liljenqvist - Münster

Norddeutsche Orthopädenvereinigung. 54. Jahrestagung der Norddeutschen Orthopädenvereinigung e.V.. Hamburg, 16.-18.06.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05novEP119

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/nov2005/05nov183.shtml

Veröffentlicht: 13. Juni 2005

© 2005 Schneider et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Introduction

The most recommended therapy for juvenile kyphosis with a Cobb-angle over 50° is the brace treatment in combination with physiotherapy.

In this study we analyzed the effectiveness of brace treatment, and also examined the influence of other variables (duration of therapy,

frequency of exercises, and the degree of patient compliance) on treatment outcome.

Methods

n=40 with FU >1 year after brace treatment (2,3 years)

Retrospective radiometric analysis of lateral radiographs before, during and after brace treatment, with a mean follow-up of 2.3 years. 29 male and 11 female patients with an average age of 13.9 years at the beginning of the therapy were evaluated. The average period of therapy was 2.7 years.The angles of the maximal kyphosis, the thoracic kyphosis (Th 4-12), the peri-apical vertebrae of the kyphosis (2-4 vertebrae), the Beck´s - index of the most wedging vertebra, the cervical-lordosis and also the perpendicular aberration were measured according to the method of Cobb. Additionally visual analog scales for pain and the overall strain (psychological and physiological) were analyzed.

Results

The maximal kyphosis was corrected from 60º to 47º in the brace and to 55º at the follow-up. The kyphosis between Th4-Th12 was 57º before, 44º in the brace and 53º at the final evaluation.

No significant correction was found of the peri-apical vertebrae (29.7º - 25º - 29.6º) and of the Beck´s- index (0.73 - 0.76 - 0.75).

There was no significant correction of the lumbal-lordosis from 38.8º to 35.4º in the brace to 29.1º in the follow-up. The perpendicular aberration from C7 to S1 was 2.8 cm before, 2.4 cm during and 4.0 cm after brace therapy.

No correlation was found between the correction and the duration of therapy, the age and the frequency of physiotherapy.

There was a non significant pain reduction from 2.4 to 1.7 on the VAS. The overall strain during the brace therapy was rated with 6.7 (10=intolerable- 0=no strain) on the VAS.

Discussion

The brace treatment of Scheuermann-kyphosis is, to a moderate extent, an effective therapy in respect of the thoracic and maximal kyphosis. A recovery of the apophysis and a reversibility of the vertebral wedging could, comparable to the conservative scoliosis therapy, not be proved. In respect to the extent of correction, the psychological and physiological strain, and the lack of studies about the spontaneous progression of the Scheuermann-kyphosis, the indication for a brace treatment should be scrutinized critically.