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Clinics in Sports Medicine Jul 2012Young athletes may have a spinal deformity incidentally or potentially related to their sport. These athletes should be encouraged to continue sports participation in... (Review)
Review
Young athletes may have a spinal deformity incidentally or potentially related to their sport. These athletes should be encouraged to continue sports participation in many instances. Brace wear is commonly used for kyphotic and scoliosis deformities. Many sports can be played in the brace. Even with sports that cannot practically be played in the brace, most bracing protocols have enough time out of brace during the day for the athlete to continue participation. However, good physical therapy for flexibility and strengthening of the spine should be continued. Even sports that potentially aggravate the deformity may be continued in these circumstances.
Topics: Adolescent; Age Factors; Athletic Injuries; Braces; Disease Progression; Humans; Kyphosis; Musculoskeletal Abnormalities; Prevalence; Scheuermann Disease; Scoliosis; Spine; United States
PubMed: 22657994
DOI: 10.1016/j.csm.2012.03.013 -
Nederlands Tijdschrift Voor Geneeskunde 2013A 56-year-old man was treated with bisphosphonates following incidental findings of vertebral deformities on a chest radiograph taken for cough. After re-evaluation with... (Review)
Review
A 56-year-old man was treated with bisphosphonates following incidental findings of vertebral deformities on a chest radiograph taken for cough. After re-evaluation with DEXA and spinal radiographs he was diagnosed with Scheuermann's disease, not osteoporosis. His gastrointestinal symptoms resolved after bisphosphonates were stopped. A 42-year-old man with limb-girdle muscular dystrophy and complaining of back pain underwent investigations. Radiographs showed loss of height in multiple thoracic vertebrae, yet DEXA bone mineral density was high-normal and an MRI scan suggested Scheuermann's disease. Recent osteoporotic vertebral fractures are an indication for anti-osteoporotic treatment, because they are highly predictive of future fracture risk. There are a number of differential diagnoses that should be considered in individuals with vertebral deformities, including Scheuermann's disease, especially if the clinical picture is not typically osteoporotic. This is important in order to avoid unnecessary medical treatment, which should be reserved for patients with osteoporosis. Refining vertebral fracture definitions may help to improve diagnostic accuracy.
Topics: Absorptiometry, Photon; Adult; Bone Density; Bone Density Conservation Agents; Diagnosis, Differential; Humans; Male; Middle Aged; Osteoporotic Fractures; Scheuermann Disease
PubMed: 24191924
DOI: No ID Found -
Journal of Surgical Orthopaedic Advances 2009A review of the current literature demonstrates considerable debate regarding the pathogenesis, natural history and treatment of Scheuermann's kyphosis. Most of the... (Review)
Review
A review of the current literature demonstrates considerable debate regarding the pathogenesis, natural history and treatment of Scheuermann's kyphosis. Most of the views and recommendations provided in various reports are weakly supported by levels of evidence. In addition, prospective studies using validated questionnaire instruments and long-term follow-ups to assess clinical outcomes in patients treated conservatively or surgically versus those untreated that would document the natural history of the condition are still unavailable. This systematic review summarizes the current knowledge on Scheuermann's kyphosis and attempts to present a rational approach in the evaluation and management of this group of patients.
Topics: Adolescent; Bone Nails; Braces; Child; Exercise Therapy; Humans; Orthopedic Procedures; Radiography; Scheuermann Disease
PubMed: 19843436
DOI: No ID Found -
Sports Medicine and Arthroscopy Review Mar 2011Back pain in the young athlete is a common finding. There are many different problems that can cause back pain in active children. It is important for the treating... (Review)
Review
Back pain in the young athlete is a common finding. There are many different problems that can cause back pain in active children. It is important for the treating physician to obtain a thorough history and physical examination to help in establishing the underlying cause for the discomfort. Appropriate imaging can be determined by these findings and further help to define the pathology. Depending upon the specific pathology, appropriate treatment may help the patient to safely return to the activities that they enjoy.
Topics: Adolescent; Athletes; Athletic Injuries; Back Pain; Bone Development; Child; Diagnostic Imaging; Humans; Intervertebral Disc Displacement; Medical History Taking; Osteoblastoma; Osteoma, Osteoid; Physical Examination; Salter-Harris Fractures; Scheuermann Disease; Scoliosis; Spinal Fractures; Spinal Neoplasms; Spondylolisthesis; Spondylolysis; Sports; Sprains and Strains
PubMed: 21293233
DOI: 10.1097/JSA.0b013e318205e373 -
Orthopedics Jan 2015A 17-year-old adolescent boy presented with progressive lower back pain and fatigue.
A 17-year-old adolescent boy presented with progressive lower back pain and fatigue.
Topics: Adolescent; Diagnosis, Differential; Humans; Low Back Pain; Male; Radiography; Scheuermann Disease; Spine
PubMed: 25611402
DOI: 10.3928/01477447-20150105-01 -
Spine Oct 1988A prospective study was undertaken to evaluate osteoporosis in Scheuermann's disease. Ten consecutive untreated patients with thoracic Scheuermann's were studied. The...
A prospective study was undertaken to evaluate osteoporosis in Scheuermann's disease. Ten consecutive untreated patients with thoracic Scheuermann's were studied. The mean age was 16 years, 1 month, and the mean kyphosis was 64 degrees. Osteoporosis was quantitated by single and dual photon absorptiometry. Seven age-, sex-, height-, and weight-matched subjects were used as controls. The mean bone mineral density (BMD) of the lumbar spine was 0.975, compared with 1.130 for the control group, significant at P less than 0.025. For patients with a kyphosis greater than 45 degrees, the BMD was 0.913, significant at P less than 0.005. The mean BMD of the femoral neck was 1.00, compared with 1.22, significant at P less than 0.005. For patients with a kyphosis greater than 45 degrees, the femoral neck BMD is 0.983, significant at P less than 0.005. The BMD of the radius by single photon absorptiometry was 0.689, compared with 0.748 in the controls, which was not significant. In patients with a kyphosis greater than 45 degrees, the BMD was 0.655, which is significant at P less than 0.01. A highly significant association exists between osteoporosis and Scheuermann's disease. Further investigation is indicated to determine the role of medical management in the treatment of these patients.
Topics: Adolescent; Bone and Bones; Femur Neck; Humans; Kyphosis; Lumbosacral Region; Minerals; Osteoporosis; Prospective Studies; Radionuclide Imaging; Scheuermann Disease; Spine
PubMed: 3206267
DOI: 10.1097/00007632-198810000-00007 -
Instructional Course Lectures 2004An increase in thoracic kyphosis in children and adolescents is usually the result of postural kyphosis or Scheuermann's kyphosis. Although no structural deformity of... (Review)
Review
An increase in thoracic kyphosis in children and adolescents is usually the result of postural kyphosis or Scheuermann's kyphosis. Although no structural deformity of the spine is observed in postural kyphosis, wedging of vertebral bodies and disk space narrowing are noted radiographically in patients with Scheuermann's kyphosis. Effective interventions for adolescents with postural kyphosis include exercises to relieve lower extremity contractures and strengthen abdominal musculature coupled with practiced normal posture in stance and in sitting. Skeletally immature patients with Scheuermann's kyphosis benefit from a similar exercise program but also require the use of a spinal orthosis. Bracing of the spine in patients with Scheuermann's kyphosis results in permanent correction of vertebral deformity, unlike bracing in patients with idiopathic scoliosis. The evaluation of children and adolescents with increased thoracic kyphosis is an important aspect of the decision process used to determine appropriate interventions.
Topics: Adolescent; Braces; Child; Humans; Kyphosis; Lumbar Vertebrae; Posture; Radiography; Scheuermann Disease
PubMed: 15116637
DOI: No ID Found -
The Orthopedic Clinics of North America Jul 1999Children and adolescents occasionally have back symptoms, but rarely come to a physician's office for more severe back pain. When a child or adolescent appears in the... (Review)
Review
Children and adolescents occasionally have back symptoms, but rarely come to a physician's office for more severe back pain. When a child or adolescent appears in the clinic with complaints of back pain, a careful detailed evaluation is appropriate. The incidence of findings in children with significant back pain is high; therefore, a detailed history, physical examination, and evaluation are needed. It is also legitimate to continue monitoring children even if no obvious cause is initially identified because often a diagnosis subsequently will be made.
Topics: Back Pain; Child; Diagnosis, Differential; Discitis; Humans; Intervertebral Disc Displacement; Scheuermann Disease; Spinal Diseases; Spinal Neoplasms; Spondylolisthesis; Spondylolysis
PubMed: 10393768
DOI: 10.1016/s0030-5898(05)70099-7 -
Spine Dec 2015Retrospective evaluation of radiographs.
STUDY DESIGN
Retrospective evaluation of radiographs.
OBJECTIVE
The aim of this study was to assess sagittal cervical balance in patients with the two types Scheuermann disease (SD).
SUMMARY OF BACKGROUND DATA
The structural hyperkyphosis characterizing SD may be localized in the thoracic (SDT) or thoraco-lumbar (SDTL) spine segments. This may affect sagittal cervical balance.
METHODS
Seventy-one patients (41 males and 30 females), aged 16.3 ± 3.8 years with SD, were enrolled into the study. On standing lateral long-cassette radiographs, the following measurements were made: C0-2 angle, C2-7 angle (CL), C1-C2 angle, relative rotation angle (RRA)-measured at levels from C2 to C7, cervical tilt (CT), thoracic inlet angle (TIA), T1 slope, neck tilt (NT), C0-angle, cranial offset (CO), and cranial tilt (CRT). Comparison with t test was performed with significance level P < 0.05.
RESULTS
There were 38 SDT and 33 SDTL patients. In SDT, the T1 slope was significantly greater than that in SDTL (38.1° vs. 28.9°; P = 0.0002), and consequently CL (-19.8° vs. -8.9°; P = 0.0160), CT (29.8° vs. 24.3°; P = 0.0190), and TIA (81.9° vs. 71.1°; P = 0.0022) in SDT were significantly greater as well. The difference in CL was expressed mainly in C6-C5 (-4.8° vs. -1.4°; P = 0.0146) and C5-C4 (-4.4°; vs. -1.5° P = 0.0464) segments. There were no significant differences in proximal cervical lordosis: C0-2 angle (-21.6° vs. -20.8°; P = 0.7597), C1-C2 angle (-30.8°vs. -27.5°; P = 0.1746), C3-C2 (-5.4° vs. -5.1°; P = 0.7976), and C4-C3 (3.5° vs. -1.5°; P = 0.1464) segments. There was no significant difference in cranial parameters C0-angle, CRT, and CO.
CONCLUSION
Scheuermann disease type has an influence on cervical sagittal balance. Localization of structural kyphosis affects the T1 slope as well as C2-C7 lordosis, cervical tilt, and thoracic inlet angle. Significant difference in C2-C7 lordosis in comparison to similar C0-2 lordosis demonstrates that compensation is present in subaxial cervical spine. Position of the head center of gravity is not dependent on the SD type.
LEVEL OF EVIDENCE
4.
Topics: Adolescent; Adult; Cervical Vertebrae; Child; Female; Humans; Lordosis; Male; Postural Balance; Radiography; Retrospective Studies; Scheuermann Disease; Young Adult
PubMed: 26536439
DOI: 10.1097/BRS.0000000000001129 -
Acta Orthopaedica May 2023Scheuermann's disease is characterized by kyphosis and frequently mild back pain. As the level of kyphosis may progress over time, also the level of pain may increase.... (Observational Study)
Observational Study
BACKGROUND AND PURPOSE
Scheuermann's disease is characterized by kyphosis and frequently mild back pain. As the level of kyphosis may progress over time, also the level of pain may increase. We evaluated the prevalence of Scheuermann's disease, and their pain, in Swedish elderly men.
PATIENTS AND METHODS
The Osteoporotic Fractures in Men (MrOS) Study Sweden (n = 3,014) is a population-based prospective observational study of community-living men aged 69-81 years. At baseline, participants answered a questionnaire including history of neck/back pain during the preceding year and characteristics of any pain (severity, sciatica, and neurological deficits). Lateral thoracic/lumbar spine radiographs were taken of 1,453 men. We included the 1,417 men with readable radiographs. Scheuermann's disease was defined as 3 or more consecutive vertebrae with > 5° wedging with no other explanation for the deformity.
RESULTS
92 of the 1,417 men (6.5%, 95% confidence interval 5.3-7.9) had Scheuermann's disease. 31% of men with and 31% without Scheuermann's disease reported neck pain (P = 0.90) and 51% with and 55% without the disease reported back pain (P = 0.4). Among men with Scheuermann's disease and back pain, none reported severe pain, 57% moderate, and 43% mild, compared with 7%, 50%, and 44% in those without Scheuermann's disease (P = 0.2). In those with Scheuermann's disease 63% reported no sciatica, 15% sciatica without neurological deficits, and 22% sciatica with neurological deficits, compared with 56%, 16%, and 28% in those without the disease (P = 0.6).
CONCLUSION
The prevalence of Scheuermann's disease in elderly Swedish men is between 5.3% and 7.9%. The condition seems at this age not to be associated with neck or back pain.
Topics: Male; Aged; Humans; Scheuermann Disease; Sweden; Cohort Studies; Back Pain; Lumbar Vertebrae; Sciatica
PubMed: 37170780
DOI: 10.2340/17453674.2023.12358