The Journal of Bone and Joint Surgery, Vol 75, Issue 2 236-248, Copyright © 1993 by Journal of Bone and Joint Surgery, Inc
The natural history and long-term follow-up of Scheuermann kyphosis
PM Murray, SL Weinstein and KF Spratt
Department of Orthopaedic Surgery, University of Iowa Hospital, Iowa City 52242.
Sixty-seven patients who had a diagnosis of Scheuermann kyphosis and a mean
angle of kyphosis of 71 degrees were evaluated after an average follow-up
of thirty-two years (range, ten to forty-eight years) after the diagnosis.
All sixty-seven patients completed a questionnaire; fifty-four had a
physical examination and radiographs; fifty-two, pulmonary function
testing; and forty-five, strength-testing of the trunk muscles. The results
were compared with those in a control group of thirty-four subjects who
were matched for age and sex. The patients who had Scheuermann kyphosis had
more intense back pain, jobs that tended to have lower requirements for
activity, less range of motion of extension of the trunk and less-strong
extension of the trunk, and different localization of the pain. No
significant differences between the patients and the control subjects were
demonstrated for level of education, number of days absent from work
because of low-back pain, extent that the pain interfered with activities
of daily living, presence of numbness in the lower extremities,
self-consciousness, self-esteem, social limitations, use of medication for
back pain, or level of recreational activities. Also, the patients reported
little preoccupation with their physical appearance. Normal or above-normal
averages for pulmonary function were found in patients in whom the kyphosis
was less than 100 degrees. Patients in whom the kyphosis was more than 100
degrees and the apex of the curve was in the first to eighth thoracic
segments had restrictive lung disease. Five patients had an unexplained,
mildly abnormal neurological examination. Mild scoliosis was common;
spondylolisthesis was not observed.
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