Scheuermann's Kyphosis & Spinal Deformities
What is Scheuermann’s Kyphosis?
The inward and outward curves of the spine aid in balance and stability. Together, these curves permit our spine to have an ideal range of motion.
In particular, the spine has two alternating curves: inward (lordosis) and outward (kyphosis). These two curves act to balance each other out. However, if either curve becomes too extreme, issues can occur. Scheuermann’s kyphosis, also known as Scheuermann’s disease, Calvé disease, and juvenile osteochondrosis of the spine, primarily affects children. The kyphosis part refers to an extreme hump in the thoracic spine (or upper back). Specifically, this disorder causes thoracic kyphosis, a form of spinal deformity more commonly known as hunchback. Since the thoracic spine also connects to the lumbar spine, hyperlordosis of the lower back or swayback may also occur.
But, why does Scheuerman’s kyphosis occur? The vertebrae in our spine are stacked in a cylindrical shape, working together to keep the spine in an upright position. Scheuermann’s kyphosis occurs during a child’s development, before the spine is skeletally mature. Whereas the back and front of the vertebral bodies should grow at an equal rate, Scheuermann’s kyphosis results when the back of the vertebra grow at an even quicker rate than the front.
Furthermore, this uneven growth often causes the vertebrae to grow in a wedge shape, therefore making the stacked spinal column bend forward rather than staying upright. In addition to a change in vertebral shape, endplate irregularities, called Schmorl’s nodes, may also result. These are caused by a disc pushing through the endplate of a bone and into a nearby vertebra. Disc herniations, or ruptured discs, often occur during this process.
In addition, Scheuermann’s kyphosis can run in families, but no clear cause is known. Risk factors may include juvenile osteoporosis, various endocrine disorders, malabsorption, past infection, and a number of biomechanical issues. An estimated 1-8% of children will develop this condition.
How Do I Know if I Have the Symptoms of Scheuermann’s Kyphosis?
Symptoms of Scheuermann’s kyphosis most commonly occur between the ages of 10 and 15, just before puberty – a key period for skeletal growth. While some children may experience pain or limited range of movement that prompt worry, initial concerns usually involve cosmetic reasons. The appearance of a “hump” and poor posture (such as a forward-leaning head and rounded shoulders) may cause embarrassment. In addition to altered posture, which is often the most obvious symptom, individuals may experience:
- Posture Changes: The thoracic spine may begin to hunch forward. (This should not be confused with postural kyphosis, which results from slouching)
- Pain: Upper or lower back pain
- Muscle Aches: Muscle spasms and cramps
- Weak Muscles: Fatigue and muscle stiffness, especially after sitting for long periods
- Tight Hamstrings: Stiff muscles in the back of the thighs
- Pain During Activity: Pain that worsens with activities that involve twisting or bending, like dancing or gymnastics; finding it hard to complete everyday activities
- Inflammation: Redness or soreness of the skin where the curves are at their worst
- Balance: Unsteady walking
- Spinal Stenosis: The back can curve in such a way that the spinal cord becomes pinched, causing numbness, tingling and pain.
- Herniated Discs: As the spine bends in more and more extreme angles, spinal discs may rupture.
It is extremely rare for Scheuermann’s kyphosis to cause serious damage. However, it is possible for the disease to progress in such a way that heart, lung, and brain function become impaired. If this becomes true for you, surgical treatment may be needed to correct the problem.
How Dr. Lowenstein Can Help
If you are concerned your child may have Scheuermann’s kyphosis, do not hesitate to call the Lowenstein team. We are here to help you through the diagnostic process and to develop a treatment plan that will work for your child. Doctors can often diagnose Scheuermann’s kyphosis with an x-ray, through which vertebral wedging is easily visible. In addition, a physical exam can allow your doctor to observe posture, range of motion, and muscle strength. Because children are still growing, observation of the condition and ongoing assessment of the spine are important to determine the best course of action. Monitoring and tracking the curvature through periodic x-rays and tests will determine the next steps to take.
If the spinal curvature exceeds 45 degrees or more, and the patient has 3 or more adjacent vertebrae wedged by at least 5 degrees per segment, your doctor can make a diagnosis of Scheuermann’s kyphosis. Treatment depends on the severity of the condition and on how much the child’s spine can still grow. If conservative treatment is required there are options such as prescription pain relievers and anti-inflammatory medications, back bracing, individualized exercise programs, and physical therapy. For more serious cases, your doctor may advise operative treatment. Scheuermann’s kyphosis, in most cases, has an excellent prognosis with proper treatment. Dr. Jason Lowenstein and his spine surgery team are here to help you with the future of your child’s spinal health. Call us today to book your first appointment.