Scheuermann's disease is a growth disorder of the vertebrae. It usually occurs in the middle and lower thoracic spine. Scheuermann's disease occurs relatively frequently in adolescents. In most cases, the disease can be managed well with conservative treatment. Surgery is only necessary in rare exceptional cases.
Here you will find further information and selected specialists for Scheuermann's disease.
Correct posture is defined as shoulders that are pulled back and a straightened back. Scheuermann's disease, however, is characterized by a pronounced h unchback. This is caused by a change in the shape of the vertebral bodies and a backward curvature of the spine.
Other names for Scheuermann's disease are
It is also known colloquially as humpback or apprentice's back.
With a disease incidence of around 20 percent, Scheuermann's disease is one of the most common diseases in adolescence. In the population as a whole, around 4 to 6 percent of people are affected. Males are affected at least twice as often as females.
In a normal, healthy state, the human spine has a double curvature:
If the angle of curvature of the kyphosis is more than 40 degrees, this is referred to as Scheuermann's disease. Severe kyphosis occurs when the angle of curvature is more than 70 degrees.
From around the age of 11, the disease can be detected by clinical abnormalities and radiologically visible changes. By the end of pubertal growth, the pathological changes in the vertebral bodies have stabilized, but the physical changes remain.
In most adolescents, the disease is diagnosed between the ages of 11 and 17.
On the left a normally curved spine, on the right a spine with Scheuermann's disease © Matthieu | AdobeStock
Normally, the vertebral bodies are shaped like cylinders. In Scheuermann's disease, however, a growth disorder causes the vertebrae to grow more slowly on the front side than on the back. This causes the vertebrae to develop a wedge shape (wedge vertebrae).
In most cases, the vertebrae of the middle and lower thoracic spine are affected. More rarely, the disorder also affects the lumbar vertebrae or the vertebrae in the transition area between the thoracic and lumbar spine.
Schmorl's cartilage nodules are also typical of Scheuermann's disease. This is intervertebral disc tissue that has broken into the bone substance on the base and top plates of the vertebrae.
Researchers suspect a genetic predisposition for the growth disorder of the vertebrae. However, the exact cause of the disease is still the subject of scientific research.
One frequently discussed theory is that the disorder is caused by mineralization and ossification processes during the pubertal growth phase. Diseases such as childhood osteoporosis or an excess of growth hormones are therefore also suspected.
Anatomy of the spine with normally grown vertebral bodies © bilderzwerg | AdobeStock
There are also external influences that could promote the development of Scheuermann's disease. These include
In the early stages, Scheuermann's disease often causes no problems or pain. If the thoracic spine is affected, there is a clearly visible curvature.
In the thoracic spine, the disease manifests itself as a hunched back. In the lumbar spine, however, the back is straight, not curved forward as usual (flat back).
However,back pain often only occurs as the disease progresses. It can worsen during physical activity and improve at rest. The pain usually improves once the body has finished growing.
The clinical symptoms as the disease progresses and in adults essentially depend on the degree of curvature. Under certain circumstances it can lead to
can occur.
In addition, the hunchback can worsen over time. This condition is known as post-Scheuermann's syndrome. Scheuermann's disease places extreme demands on the back muscles, which are constantly overloaded. This can lead to pain.
People with a hunched back have an increased risk of chronic back pain compared to the general population.
The following symptoms and long-term complications can therefore occur with Scheuermann's disease:
Young patients usually consult a doctor due to the development of a rounded back and/or back pain.
The doctor asks the patient about
The specialist then assesses the following as part of a physical examination
Finally, an X-ray of the thoracic and lumbar spine provides certainty as to whether excessive kyphosis is present. X-rays can also be used to identify the typical wedge-shaped vertebral bodies and Schmorl's cartilage nodules.
Only in very rare cases is magnetic resonance imaging(MRI) or computer tomography(CT) necessary. Specific laboratory tests or histological examinations are not usually necessary for the diagnosis.
During the growth phase, adolescents should have their spinal deformity checked at regular intervals. In this way, it can be determined whether the spinal deformity is worsening.
Once growth is complete, check-ups are no longer necessary as long as there are no symptoms.
Whether treatment is necessary depends largely on whether
The aim of treatment is to
In principle, there are several therapeutic options. They are used individually or in combination, depending on the symptoms and angle of curvature:
In the area of lifestyle changes, for example, sleeping in a prone position on a harder mattress is recommended. Sports that compress the spine (such as jumping sports) or require a hunched back should also be avoided. In addition, do not sit in a bent position for long periods and do not subject the spine to incorrect loads.
Physiotherapy plays a central role in treatment. The therapist can significantly improve posture with special exercises to strengthen the muscles. The aim is to straighten the curved back. With a mild form of the disease, physiotherapy alone can be sufficient to achieve success.
Exercises alone do not always bring the desired success. In this case, the patient can also wear a corset or orthosis. These aids help to straighten the spine.
Wearing a corset is particularly effective during the growth phase. However, corset therapy can only be successful if the patient wears the corset all day if possible. This therefore requires a great deal of self-discipline.
The spine can be permanently supported and straightened with a corset © tatomm | AdobeStock
Drug treatment consists of the administration of painkillers and muscle relaxants.
Surgery for Scheuermann's disease is associated with considerable risks. Possible complications of the operation are
For this reason, surgery should only be indicated after careful consideration of the advantages and disadvantages. Indications are extreme exceptions, namely
In the course of the operation
The prognosis for Scheuermann's disease is generally very good, as the disease does not necessarily cause pain. The course of the disease can also be positively influenced by physiotherapy or a corset.
However, depending on the extent of the spinal deformity, complications can also occur in later adulthood. Complaints such as pain or restricted movement are to be expected if, in addition to kyphosis, there is scoliosis or an extremely flat back.
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