Scheuermann's Disease

Abnormal Kyphosis in Teens

Scheuermann's Disease, also called Scheduermann's Kyphosis or Scheuermanns Juvenile Kyphosis is a structural deformity that occurs usually in the thoracic spine - but sometimes in the lumbar spine - of adolescents between the age of 12 and 15. The hallmark of Scheuermann's Disease is a noticeable deformity.

Scheuermann's Disease is congenital, meaning it is present at birth. Development of Scheuermann's  tends to correspond to the timing of the growth spurt.

The cause is not known - this is called idiopathic - but genetics likely play a role.

As is to be expected, back pain is a common symptom of Scheuermann's Disease. This is especially true early on - in other words, during the teenage years. Back pain that is associated with Scheuermann's tends to lessen as adulthood is approached. When the pain does occur, it may be located at the highest part of the kyphotic curve. People with Scheuermann's may also have tight hamstring muscles.

Scheuermann's Disease tends to lead to a higher risk of disc herniations and/or facet arthritis.

Related:  Herniated Disc and Facet Joint Pain

In general, the presence of a Scheuermann's kyphosis does not interfere with a person's regular activities, nor their career. The exception may be some blue collar positions. Chad Cook, physical therapist, clinical researcher and professor at Walsh University in Canton, Ohio says, "Scheuermann's often restricts people from performing blue collar work, especially in situations where a pre-screen for employment is done."

What Happens to a Spine With Scheuermann's Kyphosis?

A spine with Scheuermann's is characterized by wedged shaped vertebrae. The vertebrae develop in this way because the front part of the bones (i.e. the vertebral bodies) grow more slowly than the back. For reference, normal, healthy vertebrae are rectangular shaped.

As the vertebrae assume the wedge shape, their ability to line up well with one another diminishes, and poor posture develops.

Related:  Normal Spinal Curves

Deformity associated with Scheuermann's disease is most easily seen when looking at a side view of the body, with the person bending forward. The Scoliosis Research Society says that from this vantage point, you will likely see a sharp, angular abnormal kyphosis, which is caused by asymmetrical growth of adjacent vertebrae.

Because of this, kyphosis due to Scheuermann's does not correct when the person stands upright.

On the contrary, people with a postural type kyphosis in their thoracic spine (often caused by muscle imbalances between the groups that control shoulder, chest and upper back movements) generally have symmetrical growth of their vertebrae.  In this case, the kyphotic curve does disappear when they stand up straight.

A diagnosis of Scheuermann's Disease is made when the thoracic spinal curve is greater than 45 degrees (for reference.

a normal thoracic curve measures between 20 and 40 degrees), and 3 adjacent vertebrae have at least 5 degrees of wedging.

In the thoracolumbar spine (i.e. the transition area between the lumbar and thoracic spine) the kyphosis needs to be only 30 degrees for a diagnosis to be made.

How is Scheuermann's Kyphosis Treated?

For many people with Scheuermann's Disease, deformity remains mild throughout their lives. In such cases, you may only need to get an x-ray every so often.  (Talk to your doctor to be sure.)  

But the Scoliosis Research Society says that if your Scheuermann's Kyphosis is either moderate or severe (55 to 80 degrees), while your bones are still growing, you may need to wear a brace and do specific exercises prescribed by your doctor or physical therapist.

Surgery may be recommended by your doctor should the curve reach 75-80 degrees, the Scoliosis Research Society says.  

Sources

Cook, C. PT, PhD, MBA, Evidence Based Treatment of the Thoracic Spine. Medbridge Education. Accessed July 2014

Scoliosis Research Society. Kyphosis in the Adolescent and Young Adult. Scheuermann's Kyphosis/Disease. SRS website. Accessed August 2014. https://web.archive.org/web/20140701124112/http://www.srs.org/professionals/conditions_and_treatment/kyphosis_in_the_adolescent_and_young_adult/Scheuermanns_kyphosis_disease.htm

Continue Reading