Definition
Scheuermann's disease is the most frequent cause of non-postural kyphosis (curved back). This pathology is characterized by localized alterations of some dorsal vertebrae, which cause column misalignments and chronic back pain.
Scheuermann's disease occurs from adolescence, so it is typical of the developmental age. Etiology and pathogenesis are still uncertain, but Scheuermann's disease probably has hereditary genetic origins (the disorder seems to depend on the alteration of some genes also found in Marfan syndrome and imperfect osteogenesis).
The disease can also be favored by repeated microtraumas and osteochondritis of the upper and lower cartilaginous vertebral plates.
Most common symptoms and signs *
- Back pain
- hyperkyphosis
- hyperlordosis
- Backache
- Osteoporosis
- Scoliosis
- Spinal stenosis
Further indications
In Scheuermann's disease, the deformation of the vertebral bodies accentuates the dorsal kyphosis and is associated with a compensation lumbar hyperlordosis and, sometimes, a partially scoliotic column misalignment.
Most of the patients therefore have a posture with shoulders in a curved attitude towards the front (diffuse or local hypercyphosis) and a mild but persistent back pain.
In some cases, subjects with Scheuermann's disease have a similar appearance to those with Marfan syndrome, ie they have a disproportionate length of the trunk and limbs.
Radiographs of the column confirm the diagnosis, showing an anterior wedging of the vertebral bodies, generally in the lower dorsal and upper lumbar regions. In the advanced stages, the vertebral plates are irregular, with undulating surfaces, reduction of the discal spaces and reactive sclerosis (index of chronic process).
In atypical cases, generalized skeletal dysplasias and spinal tuberculosis by computerized tomography or magnetic resonance should be excluded.
The course of Scheuermann's disease is slow and can last several years. Once a state of quiescence is reached, a non-significant spinal misalignment often persists.
The treatment of mild and non-progressive cases may include the reduction of any overweight, rest in a supine position on a rigid bed and abstention from intense physical activity. When kyphosis is more severe, instead, stabilization and surgical correction of the deformation may be indicated.
