Preoperative and Postoperative Photographs and Surgical Outcomes of Patients With Kyphosis Akif Albayrak, MD, Mehmet Bulent Balioglu, MD, Abdulhamit Misir, MD, Deniz Kargin, MD, Mehmet Temel Tacal, MD, Yunus Atici, MD, and Mehmet Akif Kaygusuz, MD Study Design. A retrospective clinical study was performed. Objective. The aim of the study was to show patients their pre- and postoperative body photographs, and determine the effect on postoperative patient satisfaction for thoracic and thoraco- lumbar sharp and round angular kyphosis. Summary of Background Data. Previous studies have reported the normative values of pelvic sagittal parameters and the classification of normal patterns of sagittal curvature, but no study has investigated and compared the clinical photographs of sharp and round kyphosis. Methods. In patients who underwent surgery for thoracic and thoracolumbar sharp and round angular kyphosis, whole spine anteroposterior and lateral radiographs, and clinical photographs were obtained preoperatively and at the final follow-up. Pelvic and spinal parameters were measured, and the pre- and postoperative photographs were shown to patients. The Scoliosis Research Society 22r (SRS22r) and Short Form 36 surveys were administered to all patients, and the scores were analyzed. Results. Thirty-eight patients diagnosed with kyphosis (mean age 19.6 yr, mean follow-up duration 26.4 mo) were divided into two groups: sharp (18 patients, mean age 20.1 yr) and round (20 patients, mean age 19.6 yr) kyphosis. There was no difference between values in the sharp and round groups in terms of age, follow-up duration, and Risser score (P > 0.05). In both groups, the subscores for pain, self-image, mental health, and satisfaction, except for the function/activity score, and the total score of the SRS22r survey were, however, significantly different between pre- and postoperative photographs. In addition, there was no significant difference between the two groups in any SRS22r domain and Short Form 36 scores. Conclusion. The surgical treatment of kyphosis was uniformly associated with improved quality of life, regardless of the kyphosis type. Thus, showing patients their pre- and postopera- tive photographs may enhance patient satisfaction, as measured by SRS22r scores. Key words: clinical body photograph, cosmesis, health-related quality of life, kyphosis, outcomes, patient satisfaction, photographs, postoperative patient satisfaction, quality of life, retrospective study. Level of Evidence: 4 Spine 2016;41:E1185–E1190 K yphosis is a spine deformity in the sagittal plane that is associated with clinical and cosmetic com- plaints. Clinical problems caused by hyperkypho- sis in young patients are mostly psychosocial and self- esteem issues related to self-image. In older patients, there are, however, other issues such as disk degeneration, low back pain, and atrophy of antigravity back muscles, including the erector spinae, and mechanical issues and depression fractures may occur due to the loss of bone mineral density. 1–3 Scheuermann kyphosis is a typical disease during the adolescent period comprising vertebral endplate irregularity accompanied by wedging exceeding 58 in the Schmorl nodes and apical sequential vertebrae. 4,5 In sharp-angled, short- segment kyphosis (<3 vertebrae involved), the cause may be congenital, traumatic, or infectious. In developing countries, the most frequently encountered types are tuberculosis- related corpus and disk collapse related to sharp-angled kyphosis (i.e., gibbus). 6 Operative management has been advocated for adoles- cents with progressive kyphosis greater than 708, for those who have had progression kyphosis despite bracing, for patients with intractable back pain, and for those with an unacceptable cosmetic deformity. 7 In patients with kypho- sis, clinically and radiographically successful results can be obtained by surgical treatment. Treatment success is defined From the Department of Orthopedics and Traumatology, Spine Surgery and Arthroplasty Clinic, Metin Sabanci Baltalimani Bone Disease Education and Research Hospital, Istanbul, Turkey. Acknowledgment date: September 10, 2015. First revision date: November 18, 2015. Second revision date: January 22, 2016. Acceptance date: February 22, 2016. The manuscript submitted does not contain information about medical device(s)/drug(s). No funds were received in support of this work. No relevant financial activities outside the submitted work. Address correspondence and reprint requests to Akif Albayrak, MD, Kag ˘ı- thane Merkez Mahallesi, Ece Sok Go ¨nu ¨ levleri Sitesi C Blok Daire 5, Istanbul 34470, Turkey; E-mail: albayrakakif@gmail.com DOI: 10.1097/BRS.0000000000001573 Spine www.spinejournal.com E1185 SPINE Volume 41, Number 19, pp E1185–E1190 ß 2016 Wolters Kluwer Health, Inc. All rights reserved OUTCOMES Copyright © 2016 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.