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Scheuermann’s disease of the thoracic and lumbar spine

     
 
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Scheuermann's disease, or Scheuermann's kyphosis, is a condition in which the normal roundback in the upper spine (called a kyphosis) is increased. Most people with Scheuermann's disease will have an increased roundback (e.g. a hunch back or hump back) but no pain.

The name of this condition comes from Scheuermann, the person who in 1921 described changes in the vertebral endplates and disc space that can occur during development and lead to kyphosis, or roundback deformity of the thoracic spine (upper back).

There is some confusion in terminology, however, as Scheuermann also described changes that occur in the disc spaces of the lumbar spine that can lead to back pain. This is really another condition, called juvenile disc disorder, but is often confused with Scheuermann’s kyphosis and is sometimes called Lumbar Scheuermann’s disease. To avoid confusion, the preferred terminology is now:

  • Scheuermann’s disease (or Scheuermann’s kyphosis) to describe the condition of adolescent kyphosis
  • Juvenile disc disorder (or juvenile discogenic disorder) to describe the condition of adolescent degenerative disc disease.

Scheuermann’s kyphosis

This condition (also called Scheuermann’s disease) occurs when the front of the upper spine does not grow as fast as the back of the spine, so that the vertebrae become wedge-shaped, with the narrow part of the wedge in front. The wedge-shape of the vertebra creates an increase in the amount of normal kyphosis (front angulation of the thoracic spine) 
The wedging of vertebrae in Scheuermann’s kyphosis is most common in the thoracic spine (upper back), with the apex of the curve typically between the T7 and T9 levels of the spine. Although less common, Scheuermann’s kyphosis may also occur in the junction between the thoracic and lumbar spine (thoracolumbar spine) or in the lumbar spine (lower back).

The cause of Scheuermann's disease is unknown, but is thought to be due to a growth abnormality of the vertebral body. The growth plate anteriorly (in the front) stops growing but the posterior part of the growth plate continues to grow. This is due to a condition known as osteochondrosis.

Scheuermann’s disease does not spread and is not really a “disease” but a condition that can arise during growth. It is more common in males and appears in adolescents usually towards the end of their growth spurt.

If the roundback deformity is severe, patients are more likely to have discomfort or pain along with the deformity as they age.

 

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