Monocentric retrospective study about 64 patients after orthopaedic treatment in Scheuermann's Disease. Quality of life and incapacity scale after brace ablation
Dr Jean-Claude BERNARDa, Ms Julie DECEUNINCKa, Mr Adrien ROUGELOTa, Mr Eric BERTHONNAUDa, Dr Isabelle COURTOISb, Dr Didier FORTc
a Centre Médico-Chirurgical de Réadaptation des Massues. Croix Rouge française., b Centre Hospitalo Universitaire de St Etienne, c Médecin MPR. Nancy
Background. Spinal growth disease is commonly known as "Scheuermann's Disease" (SD) from the Danish physician who first described this illness. The prevalence is 1 to 8% and resulting in spinal pains, spinal deformations, vertebral and discal alteration. The conservative treatment occupies an important place in the care of patients to fight against spinal deformations and treating mechanical pains.
Objectives. The main objective is to evaluate the results of orthopedic treatment on clinical and laboratory functional consequences of SD on the dorsal spine, thoraco-lumbar and lumbar vertebra. The secondary objective is to know the impact of this disease on disability and quality of life away from the removal of the corset.
Population and methods. 64 teenagers (37 boys (58%) and 27 girls (42%), the average age at treatment being 14.4 years, were evaluated clinically (pain, clinical examination data) and radiologically (pelvic and spinal parameters, evolution of the deformation of the apical vertebra) at the beginning of treatment, at the end and with the biggest distance. A long time after the removal of the corset, a disability survey (Québec disability scale) and quality of life (SF36) is mailed to patients.
Results. Thoracic location of the SD (69 %), thoraco-lumbar vertebra (20 %), lumbar vertebra (3 %), complex (8 %). The pain on the spine is significantly improved on the EVA decreasing from 30 % before treatment to 2 % at the ablation of the brace then to 4 % with distance. Radiological correction of the thoracic and thoraco-lumbar kyphosis.
Discussion/Conclusion. The orthopaedic treatment is effective on the teenagers spinal pain treated for Scheuermann's disease. The efficiency of the orthopaedic treatment must be discussed according to the location of the SD: thoracic, thoraco-lumbar or lumbar. It is necessary to define more specifically the expected objectives of the conservative treatment of the SD during growth concerning the pain, the correction of the sagittal curvatures and/or the repair of the vertebral damage and if possible disc damage too.
Palazzo C,Sailhan F,Revel M. Scheuermann's disease: an update.Joint Bone Spine.2014; 81:209-14.
Keywords : Scheuermann Disease; teenagers; spinal growth disease;pain;orthopaedic treatment;pelvic and spine parameters