Scheuermann juvenile kyphosis

Last updated: May 4, 2021

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Scheuermann kyphosis is a growth-related disorder of the thoracic spine that leads to hyperkyphosis. The condition is typically diagnosed in early adolescence following a referral to the physician because of poor posture or a spinal deformity discovered in a school screening program. Subacute back pain is present in some cases. Conventional lateral spine x-rays showing > 40° of kyphosis (normal: 20–40°) and anterior vertebral wedging of > 5° of three or more adjacent vertebrae confirm the diagnosis. First-line therapy includes physical therapy and NSAIDs for pain. Bracing is used for patients with kyphosis greater than 60°, while those with kyphosis greater than 75° or neurological deficits may have to undergo spinal fusion to relieve symptoms. Although symptoms typically resolve when patients reach skeletal maturity, there may be complications such as chronic pain, permanent deformity, degenerative disc disease, spondylolysis, and spondylolisthesis in adulthood.

Epidemiological data refers to the US, unless otherwise specified.

  • Etiology unclear
  • Risk factors
    • Hereditary predisposition [2][3][4]
    • Increased height and weight in adolescence; rapid longitudinal growth [5]
    • Participation in competitive sports involving frequent flexion and extension of the trunk [6]

  • Physical therapy: to strengthen and stretch back muscles [9]
  • NSAIDS: to treat back pain
  • Bracing or casting: if kyphosis is > 60° [10]
  • Surgery (spinal fusion) is performed rarely and only in severe cases with the following features:
    • Kyphosis greater than 75° [11]
    • Persistent severe back pain
    • Neurological complications (e.g., cord compression)

We list the most important complications. The selection is not exhaustive.

  • In the majority of patients, progression of the deformity halts and few symptoms persist once skeletal development is complete.
  • Those with severe kyphosis (> 75°) can continue to have back pain and progression of the deformity. [8]
  1. Nowak, JE. Scheuermann Disease. In: Talavera F, Andary MT, Kishner S, Scheuermann Disease. New York, NY: WebMD. Updated: October 19, 2018. Accessed: February 15, 2019.
  2. Damborg F, Engell V, Andersen M, et al. Prevalence, Concordance, and Heritability of Scheuermann Kyphosis Based on a Study of Twins. J Bone Joint Surg Am. 2006; 88 (10): p.2133-2136. doi: 10.2106/jbjs.e.01302 . | Open in Read by QxMD
  3. Zaidman AM, Zaidman MN, Strokova EL, et al. The Mode of Inheritance of Scheuermann’s Disease. Biomed Res Int. 2013; 2013 : p.1-9. doi: 10.1155/2013/973716 . | Open in Read by QxMD
  4. Palazzo C, Sailhan F, Revel M. Scheuermann's disease: An update. Joint Bone Spine. 2014; 81 (3): p.209-214. doi: 10.1016/j.jbspin.2013.11.012 . | Open in Read by QxMD
  5. Fotiadis E, Kenanidis E, Samoladas E, et al. Scheuermann’s disease: focus on weight and height role. Eur Spine J. 2008; 17 (5): p.673-678. doi: 10.1007/s00586-008-0641-x . | Open in Read by QxMD
  6. Frontera W. Medical Management and Rehabilitation. In: Micheli L, Herring S, Silver J, eds. Clinical Sports Medicine. Elsevier Health Sciences ; 2007.
  7. Kado DM. Overview of hyperkyphosis in older persons. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. updated: February 4, 2019. Accessed: February 18, 2019.
  8. Mansfield JT, Bennett M. Scheuermann Disease. StatPearls. 2018 .
  9. de Mauroy JC, Weiss HR, Aulisa AG, et al. 7th SOSORT consensus paper: conservative treatment of idiopathic & Scheuermann's kyphosis. Scoliosis. 2010; 5 (1). doi: 10.1186/1748-7161-5-9 . | Open in Read by QxMD
  10. Nigrovic PA. Back pain in children and adolescents: Causes. In: Post TW, ed. UpToDate. Waltham, MA: UpToDate. updated: August 27, 2018. Accessed: February 18, 2019.
  11. Kliegman R, Stanton B, St. Geme J, Schor N. Nelson Textbook of Pediatrics. Elsevier ; 2015
  12. Lorente A, Barrios C, Lorente R, et al. Severe hyperkyphosis reduces the aerobic capacity and maximal exercise tolerance in patients with Scheuermann disease. The Spine Journal. 2019; 19 (2): p.330-338. doi: 10.1016/j.spinee.2018.07.002 . | Open in Read by QxMD
  13. Tribus C. Scheuermann Kyphosis. In: Talavera F, Shaffer W, Goldstein J, Scheuermann Kyphosis. New York, NY: WebMD. Updated: February 15, 2019. Accessed: February 18, 2019.

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