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Scheuermann's Disease

What is Scheuermann's Disease?

This disease was first observed by the Danish physician Holger Scheuermann. He was an Orthopaedic Surgeon and Radiologist in the early 1900’s. The disease is a childhood disorder of the development of the mid-back (thoracic spine). The vertebrae grow unevenly and become wedge shaped rather than square. The reason is that the front of the vertebral body grows slower than the back. This results in wedge shaped vertebral bodies. Having wedge shaped vertebrae will cause a forward curvature of the thoracic spine, called a “kyphosis”.

The most affected vertebrae are T7 and T10. Males are more commonly affected than females.

At what age does Scheuermann’s Disease start?

This disease is often first evident in the early teens. It can progress until the bones of the spine are fully grown. During that time, the disease can progress and a hunched back appears. The patient cannot straighten the spine completely.

This disease stops to progress once our bones have stopped growing.

What are the symptoms of Scheuermann’s Disease?

Here are some common symptoms of Scheuermann’s disease:

  1. Pain over the mid or low back
  2. Pain over the spine worse with weight bearing
  3. Pain over the spine with prolonged standing or sitting
  4. Forward curvature of the mid-back

How is Scheuermann’s Disease diagnosed?

  1. The diagnosis of Scheuermann’s disease is primarily made with X-Rays: The normal spinal curvature in the mid-back is 20-50 degrees forward.

A curvature of more than 50 degrees with 5 wedged vertebrae in a row is diagnosed as Scheuermann’s disease.

      2. MRI scans can also show Scheuermann’s disease, but may not be  necessary.

How is Scheuermann’s Disease treated?

Here are some of the common treatments of Scheuermann’s Disease:

  1. Non-Surgical

A. Medications

  1. Non-Steroidal Anti-Inflammatory Drugs (NSAIDS)
  2. Muscle Relaxants
  3. Pain Killers

B. Bracing

During the teenage years a specific brace (Milwaukee Brace) can be used to treat the curvature in the spine.

C. Exercises

Strengthening and hamstring exercises can be helpful.

 D. Physical Therapy (PT)

PT can offer spine exercises, manual therapy, electrical muscle stimulation, aquatics, amongst others to help treat the symptoms of this disease.

E. Massage Therapy

Massage therapy can help with the muscle pain from the abnormal spine curvature.

F. Injections

Some spine injections can help with the symptoms from this disease:

1. Trigger Point Injections

2. Muscle Blocks

3. Thoracic Interlaminar Epidural Steroid Injections

G. Chiropractic Care

Chiropractic adjustments may help with some of the symptoms of patients with Scheuermann’s Disease

 

       2. Surgical

Surgery can be used to treat severe cases of Scheuermann’s disease. most commonly in the form of a Thoracic Osteotomy and Fusion.