Scheuermann’s Disease is also known as juvenile kyphosis or Scheuermann kyphosis. It is a disorder of the thoracic or thoracolumbar region of the vertebral column in which the child feels severe back pain along with kyphosis of the spinal column.
Also, some regional changes happen in the vertebral bodies. Namely, they can become wedge shaped, which affects the overall structure of the spine.
- This disease happens in almost 5% of the general population. The range can vary between 0.4 to 8%
- There is a slightly higher male predominance in the prevalence of this disease.
The exact etiology is not known yet but it is proposed that the apophyseal rings of vertebral bodies are affected by aseptic necrosis – where blood flow to the bones is reduced, which lead to the death of bone tissue. Frequent heavy weight lifting practice also contributes to the necrosis of vertebrae.
It has also been discovered that this disease has a strong hereditary predisposition (runs in families), suggesting that the pattern of inheritance may be autosomal dominant – meaning that only one copy of the gene that causes this disease needs to be present to trigger the onset of this disease.
How this spinal deformity develops can be described as follows.
When humans go through developmental stages, the body follows a natural growth path across all structures of the body. In patients with Scheuermann disease, this development across the spine is not synchronised, and the front of the spine develops at a slower pace compared to the back layer. As a result, the spine curves outward towards the back in an exaggerated manner.
This uneven growth of the spinal bones can cause some of them to have altered shapes and form incorrectly, leading to a variety of issues.
Classification of Scheuermann’s Disease
This disease is classified into the following two types:
- Type 1 – This involves only the thoracic spine, manifesting as thoracic kyphosis.
- Type 2 – This variety can present as increased kyphosis and involves both the lower part of the thoracic vertebral column as well as the lumbar spine.
Symptoms of Scheuermann’s Disease
Symptoms of this disease usually emerge between the age of ten and fifteen years. This is the time when considerable growth of the vertebral column happens. There may be many signs and symptoms of this condition, but patients with this spinal deformity typically experience the following:
- Muscles stiffness and fatigue, especially after spending a day involving prolonged periods of sitting.
- The prominence of the curvature of the vertebral column is shifted outward, leading to a visible deformity of the vertebral column either in the thoracic region or the thoracolumbar region
- Poor posture
- Erythema (rash/irritation) of the skin when the prominence of spinal column rubs with the back of the chair.
- Back pain, which is intermittent and often aggravated by certain activities like bending, moving from side to side, twisting, dancing, participating in gymnastics and other sports needing these types of activities. The cervical spine can be affected in this case as well, leading to neck pain.
- The deformity can have an impact on one’s ability to work out
- Reduced flexibility of the vertebral column
- Balance issues
It must be noted that there are very few chances of serious damage to the spinal column when this condition is present, but harm, or damage of some sort to the spinal column, spinal cord and internal organs of the body is still possible.
This can happen because the vertebral column is protruding excessively in the forward direction (excessive kyphosis/hyperkyphosis), leading to the lungs being compressed and further resulting in breathing problems.
Non-Operative Treatment Options for Scheuermann’s Disease
The treatment for this condition depends upon the nature and severity of the disease. The factors determining the prognosis of the disease are:
- The severity of the curvature in the vertebral column, as well as its positioning (be it only in the thoracic region of the spine or both thoracic and lumbar regions)
- Amount of flexibility in the affected region of the vertebral column
- The bone growth stage of the patient, if the patient is in still in a growing stage (age and development-wise)? Is the spinal column of the patient is expected to grow more from this point onward?
- Whether the patient is concerned about the appearance.
- What are the preferences of the patient?
When choosing a treatment for Scheuermann’s disease, it is beneficial to understand the anatomy of all the regions of the vertebral column.
The vertebral column of human beings has three normal anatomical curvatures which aid in the functions of the spinal column. If at any point the curvature of the vertebral column exceeds 45 degrees, it is considered to be an abnormal formation.
If the abnormal curvature is not addressed, there is a possibility for the condition to worsen and for it to result in chronic pain and disfigurement with the passage of time.
That being said, some of the most common ways to address this condition include:
- Anti-inflammatory medication for temporary pain relief
- Physical therapy to restore mobility in the spine
- Exercises to relieve back pain
- Alternatively, one can use a spinal decompression device to relieve back pain caused by this disorder