Health-related quality of life outcomes in adolescent Scheuermann's kyphosis patients treated with posterior spinal fusion: A comparison with age- and sex-matched controls

Eetu N Suominen; Antti J Saarinen; Johanna Syvänen; Elias Diarbakerli; Linda Helenius; Paul Gerdhem; Ilkka Helenius

doi:10.1177/18632521221106384

Health-related quality of life outcomes in adolescent Scheuermann's kyphosis patients treated with posterior spinal fusion: A comparison with age- and sex-matched controls

J Child Orthop. 2022 Aug;16(4):290-296. doi: 10.1177/18632521221106384. Epub 2022 Aug 2.

Authors

Eetu N Suominen^{1

2}, Antti J Saarinen^{1

2}, Johanna Syvänen², Elias Diarbakerli^{3

4}, Linda Helenius⁵, Paul Gerdhem^{3

4}, Ilkka Helenius¹

Affiliations

¹ Department of Orthopaedics and Traumatology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
² Department of Paediatric Orthopaedic Surgery, University of Turku and Turku University Hospital, Turku, Finland.
³ Department of Clinical Science, Intervention and Technology (CLINTEC), Karolinska Institutet, Stockholm, Sweden.
⁴ Department of Reconstructive Orthopaedics, Karolinska University Hospital, Stockholm, Sweden.
⁵ Department of Anaesthesia and Intensive Care, University of Turku and Turku University Hospital, Turku, Finland.

Abstract

Purpose: To assess the health-related quality of life and radiographic outcomes of surgically treated adolescent Scheuermann's kyphosis patients after minimum of 2-year follow-up and to compare the health-related quality of life with age- and sex-matched healthy controls.

Methods: Twenty-two consecutive adolescents (mean age = 16.7 years) undergoing posterior spinal fusion for Scheuermann's kyphosis were included and matched by age and sex with two healthy controls. The health-related quality of life was evaluated using the Scoliosis Research Society-24 questionnaire. Radiographic parameters were measured for comparison preoperatively and at 6 months and 2-year follow-ups. The health-related quality of life parameters were compared with healthy controls at 2 years of follow-up.

Results: The mean maximal thoracic kyphosis improved from 79° (range = 75°-90°) to 55° (range = 45°-75°) (p < 0.001), and the mean lumbar lordosis was reduced from 71° (range = 51°-107°) to 52° (range = 34°-68°) (p < 0.001) after 2 years postoperatively. Incidence of proximal junctional kyphosis (PJK) was 18%. The scores of the Scoliosis Research Society-24 improved, with statistical significance observed in pain and self-image domains from preoperative to 2-year follow-up (p = 0.002 in both domains). The self-image and function were significantly lower in the operated patients at their 2-year follow-up visit compared to controls (p = 0.023 for self-image and p < 0.001 for function).

Conclusion: Instrumented posterior spinal fusion improves the health-related quality of life of Scheuermann's kyphosis patients during the 2-year follow-up. The greatest improvement is observed in pain and self-image domains. The health-related quality of life in pain and activity domains reaches the level of healthy individuals, while function and self-image remain at a statistically lower level.

Keywords: Scheuermann’s disease; Scoliosis Research Society-22r; Scoliosis Research Society-24; Thoracic kyphosis; health-related quality of life.