Our Summary

Scheuermann’s disease is the second most common spinal deformity in growing children, following various types of scoliosis. When detected early and with a mild curvature of the spine (kyphotic deformity), non-surgical treatment such as wearing a brace and physiotherapy can be very effective. However, if the patient shows neurological problems, if the curve in the spine continues to worsen despite treatment, or if the patient suffers from increasing pain with a certain angle of curvature over 70-75 degrees, then surgery may be necessary. The type of surgery will depend on the surgeon’s experience and could involve either fusing the spine from the back with a prior release from the front, or using screws and rods from the back with removal of part of the bone. When deciding on the extent of the operation, including which vertebrae to treat and the method of straightening the spine, care should be taken to avoid complications such as additional curvature of the spine at the top or bottom of the treated area.

FAQs

  1. What is Scheuermann’s disease and how common is it in children?
  2. Under what circumstances might surgery be necessary for a child with Scheuermann’s disease?
  3. What factors influence the type of surgery performed for pediatric scoliosis?

Doctor’s Tip

The doctor may advise the patient and their family to carefully follow post-operative instructions, including restrictions on physical activity and proper wound care, to ensure a successful recovery. Physical therapy may also be recommended to help strengthen the muscles around the spine and improve range of motion. Regular follow-up appointments will be necessary to monitor the progress of the spine and ensure that any potential complications are addressed promptly. Overall, the doctor will emphasize the importance of ongoing care and communication to achieve the best possible outcome for the patient.

Suitable For

Additionally, patients with congenital scoliosis, neuromuscular scoliosis (such as in patients with cerebral palsy or muscular dystrophy), or idiopathic scoliosis with severe curvature may also be recommended for pediatric scoliosis surgery. These patients may experience significant pain, difficulty breathing, or other complications due to the curvature of their spine, and surgery may be necessary to correct the deformity and improve their quality of life. It is important for patients and their families to discuss the risks and benefits of surgery with their healthcare provider and to carefully consider all treatment options before making a decision.

Timeline

Before pediatric scoliosis surgery:

  1. Patient is diagnosed with Scheuermann’s disease or severe scoliosis.
  2. Non-surgical treatments such as bracing and physiotherapy are attempted.
  3. If the curvature of the spine worsens, the patient experiences neurological problems, or suffers from increasing pain, surgery may be recommended.

After pediatric scoliosis surgery:

  1. Patient undergoes surgery to correct the curvature of the spine.
  2. Recovery period in the hospital, which may involve pain management and physical therapy.
  3. Follow-up appointments with the surgeon to monitor progress and ensure proper healing.
  4. Patient gradually returns to normal activities, with restrictions on certain physical activities.
  5. Long-term follow-up to monitor the spine’s alignment and prevent future complications.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with pediatric scoliosis surgery?

  2. How long is the recovery process after pediatric scoliosis surgery, and what can be expected in terms of pain management and physical therapy?

  3. What are the long-term outcomes of pediatric scoliosis surgery, and how likely is it that the curvature of the spine will be corrected successfully?

  4. Will my child need to wear a brace or undergo additional treatments after surgery to maintain the results?

  5. How experienced are you in performing pediatric scoliosis surgery, and what is your success rate with this procedure?

  6. Are there any alternative treatments or less invasive options that could be considered before deciding on surgery?

  7. What type of anesthesia will be used during the surgery, and are there any specific pre-operative preparations that need to be made?

  8. How will the surgery affect my child’s growth and development, and are there any potential long-term effects on their overall health?

  9. Will my child need to undergo any additional imaging tests or follow-up appointments after surgery to monitor their progress?

  10. What is the expected timeline for scheduling the surgery, and what support resources are available for both the child and their family throughout the process?

Reference

Authors: Diaremes P, Braun S, Meurer A. Journal: Orthopade. 2022 Apr;51(4):339-348. doi: 10.1007/s00132-022-04239-4. Epub 2022 Mar 15. PMID: 35290495