Scheuermann’s disease

Scheuermann’s disease is considered a form of juvenile osteochondrosis of the spine. It is found mostly in teenagers and presents a significantly worse deformity than postural kyphosis. Patients suffering with Scheuermann’s kyphosis cannot consciously correct their posture. The apex of their curve, located in the thoracic vertebrae, is quite rigid. The sufferer may feel pain at this apex, which can be aggravated by physical activity and by long periods of standing or sitting; this can have a significantly detrimental effect to their lives as their level of activity is curbed by their condition and they may feel isolated or uneasy amongst their peers if they are children, depending on the level of deformity. Also, the decreased level of height will emphasize body fat around the intestines, making the person with Scheuermann’s kyphosis seem more heavy-set than normal. This can make children even more uneasy, with a possibility of being harassed by peers, since they appear to be “fatter” than other children. Whereas in postural kyphosis the vertebrae and disks appear normal, in Scheuermann’s kyphosis they are irregular, often herniated, and wedge shaped over at least three adjacent levels.

The seventh and tenth thoracic vertebrae are most commonly affected. It causes backache and spinal curvature. In very serious cases it may cause internal problems and spinal cord damage. The curvature of the back decreases height, thus putting pressure on internal organs, wearing them out quicker than the natural aging process. A possibility of organ failure increases with long periods of time.

—Lateral radiograph of lumbar spine obtained in standing symptomatic 12-year-old girl, one of identical twins with atypical lumbar Scheuermann’s disease, reveals irregular endplates of L2 and L3 vertebrae, disk space narrowing between L1 and L2 and between L2 and L3 vertebrae, and anterior Schmorl’s nodes. Patient was asymptomatic and without deformity.
19-year-old woman, a basketball player, with 2-year history of lower back pain and evidence of Scheuermann’s disease sequelae. Axial CT scan shows well-delineated osteolytic lesion of vertebral body of L3 surrounded by sclerotic rim.

Image in a 47-year-old woman (case 33 in Table 1) who had left-sided sciatica for 6 months. Note Schmorl nodule at T11-12 (open arrowhead), endplate irregularities from T12-L1 to L2-3 (solid arrowheads), and a noncontained herniation at L5-S1 (arrow).

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