Scheuermann's
disease, or Scheuermann's kyphosis, is a condition
in which the normal roundback in the upper spine (called
a kyphosis) is increased. Most people with Scheuermann's
disease will have an increased roundback (e.g. a hunch
back or hump back) but no pain.
The name of this condition comes from Scheuermann,
the person who in 1921 described changes in the vertebral
endplates and disc space that can occur during development
and lead to kyphosis, or roundback deformity of the
thoracic spine (upper back).
There is some confusion in terminology, however, as
Scheuermann also described changes that occur in the
disc spaces of the lumbar spine that can lead to back
pain. This is really another condition, called juvenile
disc disorder, but is often confused with Scheuermanns
kyphosis and is sometimes called Lumbar Scheuermanns
disease. To avoid confusion, the preferred terminology
is now:
-
Scheuermanns disease (or Scheuermanns
kyphosis) to describe the condition of adolescent
kyphosis
-
Juvenile disc disorder (or juvenile
discogenic disorder) to describe the condition
of adolescent degenerative disc disease.
Scheuermanns kyphosis
This condition (also called Scheuermanns disease) occurs when the front
of the upper spine does not grow as fast as the back of the spine, so that
the vertebrae become wedge-shaped, with the narrow part of the wedge in front.
The wedge-shape of the vertebra creates an increase in the amount of normal
kyphosis (front angulation of the thoracic spine) (See Figure
1).
The wedging of vertebrae in Scheuermanns kyphosis
is most common in the thoracic spine (upper back),
with the apex of the curve typically between the T7
and T9 levels of the spine. Although less common, Scheuermanns
kyphosis may also occur in the junction between the
thoracic and lumbar spine (thoracolumbar spine) or
in the lumbar spine (lower back).
The cause of Scheuermann's disease is unknown, but
is thought to be due to a growth abnormality of the
vertebral body. The growth plate anteriorly (in the
front) stops growing but the posterior part of the
growth plate continues to grow. This is due to a condition
known as osteochondrosis.
Scheuermanns disease does not spread and is
not really a disease but a condition that
can arise during growth. It is more common in males
and appears in adolescents usually towards the end
of their growth spurt.
If the roundback deformity is severe, patients are
more likely to have discomfort or pain along with the
deformity as they age.
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