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Seminars in Musculoskeletal Radiology Oct 2023Scheuermann's disease is a rigid progressive kyphosis occurring in late childhood to adolescence. It is the most common cause of sagittal imbalance and angular...
Scheuermann's disease is a rigid progressive kyphosis occurring in late childhood to adolescence. It is the most common cause of sagittal imbalance and angular progressive kyphosis in adolescents associated with back pain. The exact etiology of the disease is unclear, but it is characterized by defective growth of the end plate that may result from excessive mechanical stress on a weakened end plate during spinal growth. Several other theories have been proposed, and it is thought to be a multifactorial disease occurring as a result of the interplay of multiple factors. The radiographic features consist of anterior vertebral body wedging, irregular end plates, Schmorl's nodes, and intervertebral disk degeneration. The natural history and evolution of this disease is also unknown. Conservative management with physiotherapy, rehabilitation, and bracing is the first line of treatment. Mechanical bracing helps prevent further progression of the kyphotic deformity. Surgery is mostly indicated in patients with failure of conservative management, with neurologic compromise, and for cosmetic reasons.
Topics: Adolescent; Humans; Child; Scheuermann Disease; Spine
PubMed: 37816360
DOI: 10.1055/s-0043-1771334 -
Journal of Back and Musculoskeletal... 2014To summarize the current knowledge relating to diagnosing and treating Scheuermann's disease. Scheuermann's disease is the most common cause of structural kyphosis in... (Review)
Review
OBJECTIVES
To summarize the current knowledge relating to diagnosing and treating Scheuermann's disease. Scheuermann's disease is the most common cause of structural kyphosis in adolescence.
METHODS
A literature-based narrative review of English language medical literature.
RESULTS AND CONCLUSIONS
Recent studies have revealed a major genetic contribution (a dominant autosomal inheritance pattern with high penetrance and variable expressivity) to the etiology of Scheuermann kyphosis with a smaller environmental component (most probably mechanical factors). The natural history of Scheuermann kyphosis remains controversial, with conflicting reports as to the severity of pain and physical disability. Since we cannot predict which kyphotic curves will progress, we are unable to determine effectiveness of brace treatment. Physical therapy is scarcely mentioned in the literature as an effective treatment for Scheuermann kyphosis. Although there is little evidence that physical therapy alone can alter the natural history of Scheuermann's disease, it is often used as the first choice of treatment. Brace treatment appears to be more effective if an early diagnosis is made, prior to the curvature angle exceeding 50° in patients continuing to grow. Surgical treatment is rarely indicated for severe kyphosis (>75°) with curve progression, refractory pain, or a neurologic deficit. Rigorous methodology clinical trials are essential to evaluate the efficacy of conservative interventions, especially different exercises and manual therapies and their combinations with braces.
Topics: Adolescent; Braces; Child; Exercise Therapy; Humans; Musculoskeletal Manipulations; Orthopedic Procedures; Physical Therapy Modalities; Prevalence; Radiography; Scheuermann Disease; Thoracic Vertebrae
PubMed: 24898440
DOI: 10.3233/BMR-140483 -
Journal of Clinical Neuroscience :... Aug 2023
Topics: Humans; Scheuermann Disease; Spine
PubMed: 37307717
DOI: 10.1016/j.jocn.2023.05.022 -
Der Orthopade Apr 2022Scheuermann's disease represents the second most common deformity of the growing spine after the various forms of scoliosis. In cases of early diagnosis and mild...
Scheuermann's disease represents the second most common deformity of the growing spine after the various forms of scoliosis. In cases of early diagnosis and mild kyphotic deformity conservative treatment with a brace and physiotherapy shows very good results; however, in cases of neurologic deficits, curve progression despite conservative treatment and increasing pain symptoms with a Stagnara angle of more than 70-75°, surgical treatment is meaningful. The surgical strategy can include posterior spondylodesis with prior anterior release or posterior instrumentation with posterior column osteotomy depending on the surgeon's experience. The choice of the extent of the operation with the vertebrae to be instrumented and including the straightening method should be oriented to the avoidance of complications, such as proximal or distal junctional kyphosis.
Topics: Humans; Osteotomy; Scheuermann Disease; Scoliosis; Spinal Fusion; Spine
PubMed: 35290495
DOI: 10.1007/s00132-022-04239-4 -
The Journal of the American Academy of... May 2019Scheuermann's kyphosis (SK) is a rigid structural deformity of the thoracic spine defined radiographically as three or more contiguous vertebrae with at least 5° of... (Review)
Review
Scheuermann's kyphosis (SK) is a rigid structural deformity of the thoracic spine defined radiographically as three or more contiguous vertebrae with at least 5° of wedging anteriorly. Prevalence of the disease is thought to be between 0.4% and 10%. The true cause of SK remains unclear; however, various theories include growth irregularities, mechanical factors, genetic factors, and/or poor bone quality as the causes. Patients with mild disease (less than 70°) generally have a favorable prognosis with good clinical outcomes. Most patients with SK are successfully treated nonsurgically with observation, anti-inflammatory medications, and physical therapy. Surgical intervention is indicated in patients with greater than 70° to 75° thoracic curves, greater than 25° to 30° thoracolumbar curves, intractable pain, neurologic deficit, cardiopulmonary compromise, or poor cosmesis. Because of advances in posterior spinal instrumentation, surgery can typically be performed through a posterior-only approach. When surgical treatment is planned, appropriate selection of the upper- and lower-instrumented vertebrae is important to achieve a well-balanced spine, preserve motion segments, and reduce the risk of junctional kyphosis.
Topics: Anti-Inflammatory Agents; Conservative Treatment; Humans; Physical Therapy Modalities; Radiography; Scheuermann Disease; Spinal Fusion; Thoracic Vertebrae
PubMed: 30407981
DOI: 10.5435/JAAOS-D-17-00748 -
Joint Bone Spine May 2014Scheuermann's disease is a juvenile osteochondrosis of the spine. It is a disease of the growth cartilage endplate, probably due to repetitive strain on the growth... (Review)
Review
Scheuermann's disease is a juvenile osteochondrosis of the spine. It is a disease of the growth cartilage endplate, probably due to repetitive strain on the growth cartilage weakened by a genetic background. The radiographic aspects are related to the vertebral endplate lesions and include vertebral wedging, irregularity of the vertebral endplate, and Schmorl's node (intraossous disk herniation). Disc alterations are frequent and may be secondary to dysfunction of the disc-vertebra complex. The definitions of Scheuermann's disease are varied; it can refer to the classical form of juvenile kyphosis, described by Scheuermann as well as asymptomatic radiographic abnormalities. Lumbar involvement is probably as frequent as the thoracic form and might be more painful. The first-line treatment is medical and includes rehabilitation and bracing. The earlier the start of treatment, the better the outcome, which highlights the importance of early diagnosis. Surgery is uncommon and must be limited to severe involvement after failure of conservative treatment. The natural history of Scheuermann's disease is unknown, but it might be associated with increased risk of back pain. The evolution of thoracolumbar and lumbar disease is unknown.
Topics: Humans; Scheuermann Disease; Spine
PubMed: 24468666
DOI: 10.1016/j.jbspin.2013.11.012 -
Orthopedic Nursing
Topics: Humans; Scheuermann Disease; Radiography; Spinal Fusion
PubMed: 36702097
DOI: 10.1097/NOR.0000000000000914 -
Spine Feb 1994This study was undertaken to document an association of degenerative lumbar disc disease in patients with thoracolumbar Scheuermann's disease. During a 3-month period,...
This study was undertaken to document an association of degenerative lumbar disc disease in patients with thoracolumbar Scheuermann's disease. During a 3-month period, 9% of 1419 of the persons referred to our center for magnetic resonance imaging of the lumbar spine demonstrated changes of both thoracolumbar Scheuermann's disease and degenerative disc disease in the lower lumbar spine. The disease was less commonly detected on computed tomography (2% of 1522 patients). The patients were relatively young: 81% were younger than 40 years and 9% were younger than 21 years. We theorize that the thoracolumbar Scheuermann's disease and the associated degenerative disc disease of the lower lumbar spine are manifestations of an intrinsic defect of the discs and/or cartilaginous end plates, which results in inadequate nutrition and structural weakness or a combination of both, and early degeneration.
Topics: Adolescent; Adult; Female; Humans; Intervertebral Disc; Intervertebral Disc Displacement; Lumbar Vertebrae; Magnetic Resonance Imaging; Male; Scheuermann Disease; Thoracic Vertebrae; Tomography, X-Ray Computed
PubMed: 8171367
DOI: 10.1097/00007632-199402000-00014 -
Pediatric Clinics of North America Feb 2020Pediatric spine disorders are numerous and are quite different when compared with the adult population. This article focuses on some of the more common pediatric spine... (Review)
Review
Pediatric spine disorders are numerous and are quite different when compared with the adult population. This article focuses on some of the more common pediatric spine disorders. This article summarizes such disorders and discusses typical treatment options in the pediatric orthopedic armamentarium.
Topics: Child; Humans; Scheuermann Disease; Scoliosis; Spinal Diseases; Spondylolysis
PubMed: 31779832
DOI: 10.1016/j.pcl.2019.09.008 -
The Orthopedic Clinics of North America Jul 1999Scheuermann's disease is the most common cause of structural kyphosis in adolescence. The mode of inheritance is likely autosomal dominant and the etiology remains... (Review)
Review
Scheuermann's disease is the most common cause of structural kyphosis in adolescence. The mode of inheritance is likely autosomal dominant and the etiology remains largely unknown. Indications for treatment remain controversial because the true natural history of the disease has not been clearly defined. Brace treatment appears to be very effective if the diagnosis is made early. Surgical treatment is rarely indicated for severe kyphosis (> 75 degrees ) with curve progression, refractory pain, or neurologic deficit.
Topics: Adolescent; Humans; Scheuermann Disease
PubMed: 10393769
DOI: 10.1016/s0030-5898(05)70100-0