Question:Our 16-year-old son is going to have spinal surgery for Scheuermann's disease. I know there are complications possible with any operation. What can happen after this one? My family thinks I worry too much. But I prefer to know what to expect and prepare for the worst.
Answer:Scheuermann's kyphosis is an abnormal forward curvature of the thoracic spine. Patients with this condition have a very rounded mid-back. They appear to be very stooped forward. Kyphosis is a term that refers to this position of the spine and resulting posture.
When the kyphosis is more than 70 degrees and getting worse, then surgery is considered. Back pain and cosmetic appearance are two other reasons to manage the problem operatively.
Special hardware implants are used to help hold the spine in an upright position. Bone graft is placed between multiple levels of vertebrae to fuse the spine. As with any operation and especially one this extensive, problems can occur after surgery.
These complications can range from persistent pain to deep wound infection requiring further surgery. Other problems can include blood clots to the lungs, fractured rods or other implants, and acute kidney failure.
One common problem that has been reported is junctional kyphosis. This means the patient develops another kyphosis above the level of the fusion. Junctional kyphosis occurs in up to one-third of all patients after fusion. Loss of correction is another potential result after surgery.
Patients who have a combined anteroposterior procedure are at the greatest risk for complications. Anteroposterior means the fusion is done from both the front of the spine and the back of the spine.
Talk to your son's surgeon about your concerns before the operation. Find out what problems are possible and/or likely. There's nothing wrong with knowing what to expect. However,it may be best to avoid catastrophizing the situation -- in other words, don't discuss the operation as if the worst IS going to happen. This can be very unsettling for the child and other family members.Baron S. Lonner, MD et al. Operative Management of Scheuermann's Kyphosis in 78 Patients. In Spine. November 15, 2007. Vol. 32. No. 24. Pp. 2644-2652.
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