title: Body Mass Index in Adolescent Spinal Deformity: Comparison of Scheuermann's Kyphosis, Adolescent Idiopathic Scoliosis, and Normal Controls.
abstract: METHODS
  Prospective, multicenter study of Scheuermann's kyphosis (SK) and adolescent idiopathic scoliosis (AIS) compared to a control group.
  
  
  OBJECTIVE
  Compare body mass index (BMI) and Scoliosis Research Society Questionnaire-22 (SRS-22) scores among two diagnosis and one control group.
  
  
  BACKGROUND
  BMI has been reported as increased in SK patients; however, there are few recent data on this subject or comparing SK to AIS.
  
  
  METHODS
  Ninety-two SK patients (37 female, 55 male, average age 16 years), 1,051 AIS patients (814 female, 237 male, average age 15 years), and 380 adolescents without scoliosis (controls) were compared based on age, gender, race, height (m), weight (kg), BMI, and SRS-22 scores. An analysis of variance was used to test differences in BMI and SRS-22 scores between the groups and between males and females. Pearson correlations determined the relationship between AIS T5-T12 kyphosis and BMI, SK max kyphosis and BMI, and to determine the relationship between BMI and SRS-22 scores in each group.
  
  
  RESULTS
  More SK patients were "obese" and "overweight" (28% and 22%) compared to the AIS (6% and 9%) and Control groups (5.8% and 17.9%) (p < .001). More AIS patients were "underweight" (27%, SK: 13%, Control: 12.1%; p < .03). T5-T12 kyphosis was weakly correlated with BMI (r = 0.17), whereas max kyphosis correlated well with BMI (r = 0.39, p < .00). The SK group had significantly lower (worse) SRS-22 scores than AIS patients in the Pain (3.97 vs. 4.10), Self-Image (2.86 vs. 3.35), Mental Health (3.72 vs. 4.02), and Total Score domains (3.62 vs. 3.92, p < .001). Increased pain scores were weakly correlated with decreasing BMI in all three groups.
  
  
  CONCLUSIONS
  SK patients are at increased risk for elevated BMI and worse SRS-22 scores, indicating that they may suffer from delayed diagnosis and increased surgical complications. AIS patients are at increased risk for issues related to low BMI and should also be monitored.
authors.affiliation: Department of Orthopaedic Surgery, Beth Israel Medical Center, New York, NY 10003, USA. Electronic address: blonner@nyc.rr.com.
authors.forename: Baron S
authors.initials: BS
authors.lastname: Lonner
authors.affiliation: Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY 10003, USA.
authors.forename: Courtney S
authors.initials: CS
authors.lastname: Toombs
authors.affiliation: Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, NY 10003, USA.
authors.forename: Qasim M
authors.initials: QM
authors.lastname: Husain
authors.affiliation: Department of Orthopaedic Surgery, Johns Hopkins Hospital, Baltimore, MD 21287, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Sponseller
authors.affiliation: Department of Orthopaedic Surgery, Miami Children's Hospital, Miami, FL 33155, USA.
authors.forename: Harry
authors.initials: H
authors.lastname: Shufflebarger
authors.affiliation: Department of Orthopaedic Surgery, Nemours Children's Clinic, Wilmington, DE 19803, USA.
authors.forename: Suken A
authors.initials: SA
authors.lastname: Shah
authors.affiliation: Department of Orthopaedic Surgery, Shriners Hospitals for Children, Philadelphia, PA 19140, USA.
authors.forename: Amer F
authors.initials: AF
authors.lastname: Samdani
authors.affiliation: Department of Orthopaedic Surgery, Shriners Hospitals for Children, Philadelphia, PA 19140, USA.
authors.forename: Randal R
authors.initials: RR
authors.lastname: Betz
authors.affiliation: Department of Orthopaedic Surgery, Shriners Hospitals for Children, Philadelphia, PA 19140, USA.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Cahill
authors.affiliation: Department of Orthopaedic Surgery, Rady Children's Hospital San Diego, San Diego, CA 92123, USA.
authors.forename: Burt
authors.initials: B
authors.lastname: Yaszay
authors.affiliation: Department of Orthopaedic Surgery, Rady Children's Hospital San Diego, San Diego, CA 92123, USA.
authors.forename: Peter O
authors.initials: PO
authors.lastname: Newton
keywords: Adolescent idiopathic scoliosis; Body mass index; Health-related quality of life; Scheuermann's kyphosis; Spinal deformity