Radiological imaging findings of scheuermann disease

AIM To find accompanying anomalies of typical and atypical Scheuermann's disease(SD) is reported in the present study. METHODS Study included 20 patients(16 men and 4 women) who had radiological imaging radiography, magnetic resonance imaging(MRI) and computed tomography, if available, due to back pain, curved back and low back pain in November 2011-February 2016 period. Patients were categorized into typical and atypical patterns based on the region involved. Thoracic kyphosis values were measured using real Cobb angle. Accompanying disc degeneration, herniations and spinal cord pathologies were studied using MRI.RESULTS Age of the patients ranged from 11.0 to 23.0(mean 17.2 ± 3.0). Typical pattern of SD were detected in 15 patients while atypical pattern were detected in 5 patients. Cobb angle range was 40.2-67.2(mean 55.5 ± 8.7) in typical Scheuermann's patients and 24.7-49.9(mean 36.7 ± 10.8) in atypical ones. Intervertebral level was affected and had the measures of 3-8(mean 5.3 ± 1.6) and 7-9(mean 8.2 ± 0.8) in typical and atypical Scheuermann's patients, respectively. Level of degenerative disc disease in MRI was 1-7 discs(mean 4.1 ± 1.7) in typical patients and 5-10 discs(mean 7.6 ± 1.9) in atypical patients.CONCLUSION SD can be seen in typical and atypical patterns, typical being more frequent. Because degenerative disc diseases,herniations and cord pathologies such as syringomyelia can accompany SD(albeit more common in atypical pattern), it is necessary to evaluate these patients with plain radiography and MRI together.

Effect of spinal manipulation on degenerative scoliosis

OBJECTIVE:To investigate the effect of spinal manipulation(SM)on degenerative scoliosis by evaluating patients’visual analog scale(VAS)scores,Cobb angles,sagittal vertical axis(SVA),and apical vertebral rotation(AVR)and to explore factors that influence treatment effect.METHODS:A total of 55 patients with degenerative scoliosis received 4 weeks of SM.After treatment,patients were divided into two groups:the remission group(VAS score<40 mm)and the non-remission group(VAS score≥40 mm).Pre-versus post-treatment VAS scores,Cobb angles,SVA,and AVR were compared in each group and in the total population.Baseline data(sex,age,symptom characteristics,duration of symptoms,VAS score,Cobb angle,SVA,and AVR)were compared between groups.Factors influencing the post-treatment VAS score were explored with multiple linear regression analysis.RESULTS:No changes were found in the Cobb angle(P=0.722)or AVR(P=0.424)after intervention in the overall population.However,the SVA(P<0.001)and VAS score(P=0.000)changed significantly after treatment.Similar changes were observed in the remission group(n=29).Multiple linear regression revealed that the only factors influencing treatment effect were symptom characteristics,SVA,and VAS score.CONCLUSION:SM relieved pain and improved sagittal imbalance in patients with degenerative scoliosis.It did not lessen the severity of coronal curvature or vertebral rotation.Factors influencing the effect of SM included symptom characteristics,VAS score,and SVA.A larger randomized trial is needed to further confirm our results.