Scheuermann's disease is considered a form of juvenile osteochondrosis of the spine.
It is found mostly in teenagers and presents a significantly worse deformity than postural kyphosis. Patients suffering with Scheuermann's kyphosis cannot consciously correct their posture. The apex of their curve, located in the thoracic vertebrae, is quite rigid.
Scheuermann's Disease, or Scheuermann's Kyphosis, is an adolescent onset of spinal deformity, characterized by a rigid, "round backed" deformity to the upper spine. The seventh and tenth thoracic vertebrae are most commonly affected. It causes backache and spinal curvature. In very serious cases it may cause internal problems and spinal cord damage.
Kyphosis is the medical term for the natural forward curvature of the thoracic, or upper, spine. It becomes a disorder if the curvature is over a certain number of degrees forward, generally 40 degrees. There are several kinds of kyphotic disorders.
In this form of kyphosis, the vertebrae are not misshapen, the discs in between the vertebrae are bent forward, and the deformity is not rigid, meaning that the person can bend their spine into a straight position. This condition is easily corrected with physical therapy, exercises, and conscious effort. It's the most common form of kyphosis.
Congenital Kyphosis is a spinal deformity in which one or more of the vertebrae has not fully developed in birth and thus becomes misshapen, leading to an angular forward curve. Vertebrae may be malformed or fused together and can cause further progressive kyphosis as the child develops. In most cases, the only way to correct this is surgery.
Nutritional Kyphosis can result from nutritional deficiencies, especially during childhood, such as vitamin D deficiency (producing rickets) which softens bones and results in curving of the spine and limbs under the child's body weight.
Surgical treatment can be used in severe cases. In patients with progressive kyphotic deformity due to vertebral collapse, a procedure called a kyphoplasty may arrest the deformity and relieve the pain. The procedure is serious and consists of fusion of the abnormal vertebrae.
This form of Kyphosis remains the most mysterious. While it's known how it works and what happens to the spine because of it, the initial cause is not known. It begins to develop in early adolescence, predominantly in male children (though not unknown in females), due to the spinal columns anterior, or forward, ligament thickening. This causes the posterior end of the vertebrae to grow faster than the constricted anterior end, creating a cheese-wedge like shape of the thoracic vertebrae. The end result is a rigid, rounded appearance of the spinal column, or "hunchbacked" appearance.
Typically it's caught between the ages of 10 and 15 years old, due to a parent's concern about their child's posture, X-rays are used to determine the presence of Scheuermann's.
Treatment of mild cases involves physical therapy, possible bracing, and exercise to help provide a pain free and fulfilling existence. While rare, more severe cases (with a forward curvature over 75 degrees) are sometimes surgically treated.
Scheuermann's is typically progressive, and without proper care, can cause organ damage, paralysis, and even death. Deformities over 75 degrees are extremely painful and debilitating, and can begin to deform vertebrae in the lumbar spine as well.
Patients undergoing surgery for Scheuermann's disease often must perform routine physical therapy to manage pain and mobility often for their entire lives.