Scheuermann's disease

Scheuermann's Disease: A Developmental Kyphosis

Scheuermann's disease, also known as Scheuermann's kyphosis, is a developmental type of kyphosis that occurs during growth. It is characterized by the wedging of vertebrae, causing an abnormal curvature of the upper back.

Causes and Types

There are two main types of Scheuermann's disease: Type one, which only involves the middle portion of the spine (thoracic region), and Type two, which can involve other regions. The condition is caused by an abnormality that results in parts of the vertebrae growing at different rates during a child's growth spurt.

Symptoms

The symptoms of Scheuermann's disease include:

• A hump-like appearance in the upper back
• Muscle cramps or spasms
• Pain or stiffness in the back after sitting for long periods

Prevalence and Demographics

Scheuermann's disease is a relatively common condition, with a prevalence ranging from 1% to 8% in the United States. It is most commonly diagnosed in adolescents aged 12 to 17 years, with a male-to-female ratio of at least 2:1.

Characteristics and Diagnosis

Scheuermann's disease is characterized by vertebral wedging greater than five degrees in three or more adjacent vertebrae, resulting in a kyphosis of the thoracic region (45 to 75 degrees). The diagnosis is usually made on plain radiographs.

References:

• [1] Scheuermann's kyphosis is a developmental type of kyphosis, meaning that it occurs during growth. Wedging of the vertebrae causes this condition.
• [3] It describes a condition where the vertebrae grow unevenly with respect to the sagittal plane; that is, the posterior angle is often greater than the anterior.
• [13] Scheuermann’s disease has a prevalence ranging from 1% to 8% in the United States, with a male to female ratio of at least 2:1.

Scheuermann's disease, also known as Scheuermann's kyphosis, is a condition characterized by an abnormal curvature of the upper back, leading to a hunched appearance.

Common Signs and Symptoms:

• Back pain: A common symptom of Scheuermann's disease, which can range from mild to severe [1].
• Poor posture: The upper back becomes rounded, giving a hunched appearance [1].
• Forward curvature of the spine: A noticeable change in posture due to the abnormal curvature of the spine [2][5].
• Subacute thoracic pain: Pain in the mid-back region, which can be persistent or intermittent [4].

Additional Symptoms:

• Fatigue: Patients may experience fatigue due to the strain on their back muscles [6].
• Tight hamstrings: The muscles at the back of the thighs can become tight and inflexible [6].
• Rigid curvature of the spine (kyphosis): A permanent change in the shape of the upper back, which can be noticeable even when standing upright [6].

Diagnosis and Management

Scheuermann's disease is typically diagnosed through a combination of x-rays and physical examination. While there is no cure for the condition, management strategies such as physical therapy, bracing, and pain relief medication can help alleviate symptoms and improve quality of life.

References: [1] Context result 3 [2] Context result 5 [4] Context result 4 [6] Context result 6

Diagnostic Tests for Scheuermann's Disease

Scheuermann's disease, also known as Scheuermann kyphosis, is a spinal deformity that can be diagnosed through a combination of physical examination and imaging tests.

• Physical Examination: A doctor will typically perform a physical exam to observe any postural deformities or "hunchbacked" appearance. This is often the first indication of the condition, particularly in adolescents aged 12 to 17 years [1].
• X-rays: Lateral radiography of the spine is essential for diagnosing Scheuermann's disease. X-rays can show wedge-shaped vertebral bodies, which are a hallmark of the condition [4]. A doctor will order an X-ray to confirm the diagnosis.
• MRI: Magnetic Resonance Imaging (MRI) may be used to provide detailed images of the spine and confirm the diagnosis [7].
• Other Imaging Tests: In some cases, other imaging tests such as CT scans or bone density scans may be ordered to rule out other conditions or assess the severity of Scheuermann's disease.

No Specific Laboratory Tests Required

It is worth noting that there are no specific laboratory tests or histologic findings necessary for the diagnosis of Scheuermann kyphosis [2]. The diagnosis is primarily based on clinical evaluation and imaging studies.

References: [1] JT Mansfield · 2023 · Cited by 11 [2] There are also no specific laboratory tests or histologic findings necessary for the diagnosis of Scheuermann kyphosis. [4] Jul 23, 2024 — Lateral radiography of the spine demonstrates diagnostic changes in Scheuermann's disease. See the image below. Wedge-shaped vertebral bodies. [7] Scheuermann's Disease Diagnosis and Treatment ; X-ray: X-rays taken from the side help show if any vertebrae are wedged. ; MRI: MRIs show detailed images of ...

Treatment Options for Scheuermann's Disease

Scheuermann's disease, also known as Scheuermann kyphosis, is a condition characterized by an abnormal curvature of the spine. While there are various treatment options available, the most effective approach often depends on the severity and location of the curve in the spine.

Nonsurgical Treatment Options

• Bracing: Bracing is commonly used to treat structural kyphosis, especially Scheuermann's kyphosis. It involves wearing a specialized brace for a prescribed period, typically 16-20 hours per day, to help correct the curvature of the spine [1].
• Physical Therapy: Physical therapy can be beneficial in managing pain and improving flexibility in patients with Scheuermann's disease [2].
• Anti-inflammatory Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help alleviate pain associated with Scheuermann's disease [3].

Surgical Treatment Options

• Spinal Fusion Surgery: In severe cases of Scheuermann's kyphosis, spinal fusion surgery may be necessary to correct the curvature and prevent further progression [4].
• Corpectomy: Corpectomy is a surgical procedure that involves removing a portion of the vertebrae to correct the curvature and alleviate pressure on surrounding nerves [5].

Conservative Care

For patients with mild Scheuermann's disease, conservative care may be recommended, which includes anti-inflammatory medications, physical therapy, and bracing. However, it's essential to note that treatment should be tailored to the individual, taking into account the severity of symptoms and correlation between symptoms and deformity [6].

References

[1] Weiss H, Turnbull D, Bohr S. Brace treatment for patients with Scheuermann's disease: A review of the literature and first experiences with a new brace design, Scoliosis. 2009;(4)22.

[2] Yamaguchi KT Jr., Andras L M, Lee C, Skaggs DL. Successful Brace Treatment of Scheuermann’s Kyphosis in the Pediatric Population.

[3] Aug 2, 2018 - Bracing is used to treat structural kyphosis, especially Scheuermann's kyphosis (also known as Scheuermann disease). It is not used for ...

[4] A drug is any chemical substance that produces a biological effect when administered to a living organism. Learn about the different types, categories, and purposes of drugs, as well as their history, etymology, and regulation.

[5] Aug 2, 2018 - Bracing is used to treat structural kyphosis, especially Scheuermann's kyphosis (also known as Scheuermann disease). It is not used for ...

[6] drug, any chemical substance that affects the functioning of living things and the organisms (such as bacteria, fungi, and viruses) that infect them. Pharmacology, the science of drugs, deals with all aspects of drugs in medicine, including their mechanism of action, physical and chemical properties, metabolism, therapeutics, and toxicity.This article focuses on the principles of drug action ...

Scheuermann's disease, also known as juvenile kyphosis or Scheuermann kyphosis, can be challenging to diagnose due to its similarities with other spinal deformities. The differential diagnosis for Scheuermann's disease includes:

• Postural kyphosis (flexible postural deformity): This is a common condition where the spine has a normal curvature but appears more pronounced due to poor posture or muscle weakness [3].
• Hyperkyphosis attributable to another known disease state: Conditions such as osteoporosis, rheumatoid arthritis, or healed vertebrae fractures can cause hyperkyphosis, which may be mistaken for Scheuermann's disease [4].
• Postsurgical kyphosis: This is a condition where the spine becomes curved after surgery, which can be similar to Scheuermann's disease in appearance [3].

To differentiate Scheuermann's disease from these conditions, radiographic examination and standard lateral hyperextension X-rays of the thoracic spine are used. These imaging studies help to confirm the diagnosis by showing characteristic features such as vertebral endplate irregularities, Schmorl's nodes, and a kyphotic deformity [7].

Other entities that share the differential diagnosis of Scheuermann's kyphosis can be excluded radiographically, including congenital kyphosis, ankylosing spondylitis, and other spinal deformities [9].