Key Points about Scheuermann's Disease (Kyphosis)

  • The cause of Scheuermann’s Disease is unknown, but it tends to run in families.
  • Symptoms of Scheuermann's Disease include hump appearance in the back, muscle cramps or spasms, pain or stiffness in the back after sitting for long periods, reduced flexibility, or pain when doing activities that require twisting.
  • Your doctor can diagnose Scheuermann’s Disease in a clinic visit with a physical exam and X-ray.
  • Treatment typically involves nonsurgical therapies such as exercises and braces. In severe cases, surgery may be necessary.
  • Schedule an appointment with your doctor if you suspect your child has Scheurmann's Disease. While serious complications are rare, they can occur, so early intervention is necessary.

Overview

Scheuermann’s disease, also known as Scheuermann’s kyphosis, Calvé disease, or juvenile osteochondrosis of the spine, is a skeletal disorder that causes irregular vertebral growth in the upper or lower back. 

In patients with Scheuermann's disease, the back of the vertebra grows normally, while the front grows slowly. When this happens, the bend in your upper back increases. It makes the back look like it is hunched over.

Many patients who have Scheurmann’s Disease also have scoliosis.

Scheuermann's Disease causes

While the cause of Scheuermann’s Disease is unknown, it tends to run in families. Factors that can impact whether your child develops Scheuermann’s Disease or not include:

  • Juvenile Osteoporosis.
  • Malabsorption.
  • Infection.
  • Disorders of the endocrine system.

Scheuermann's Disease symptoms

Symptoms of Scheuermann’s Disease typically develop between the ages of 10 and 15.

Symptoms may include:

  • Hump appearance in the back.
  • Stiffness in the back after sitting for long periods.
  • Pain when performing activities that require twisting.
  • Muscle cramps.
  • Reduced flexibility.
  • Problems exercising.
  • Mild balance issues.
  • Tight hamstrings.

Scheuermann's Disease complications

The most common complications associated with Scheuermann’s disease are chronic back pain, neurological deficits, and progressive deformity. After surgery, the most common complication is pseudoarthrosis.

Scheuermann's Disease risk factors

There are a variety of factors that can increase your risk of developing Scheuermann's Disease, including:

  • Diseases of the spine, spinal cord, or connective tissue.
  • Infections, including tuberculosis.
  • Trauma
  • Poor posture.

Scheuermann's Disease prevention

While many cases of Scheuermann’s Disease are present at birth and cannot be prevented, other cases may be prevented with correct posture, avoiding risk-taking behavior, and living a healthy lifestyle.

Scheuermann's Disease diagnosis

Your doctor can diagnose Scheuermann's disease. In a clinic visit, your doctor will take a full medical history, perform a physical exam, and order diagnostic testing such as an X-ray.

During the physical exam, the doctor will examine your child's range of motion and observe your child in a variety of positions. Your child will be observed from the front, side, back, and in a reclining position. The doctor may also examine your child's muscle strength and ask your child to bend forward toward the ground and touch their toes.

Your doctor will measure your curve in degrees. If your child has a curve more than 45 degrees or if three or more adjacent vertebrae are wedged together with at least five degrees per segment, he or she will be diagnosed with Scheuermann's disease.

Scheuermann's Disease treatment

Your doctor will develop a customized treatment plan for your child based on:

  • Size and progression of the curve.
  • Age of patient.
  • Amount of growing left in the child.
  • Level of pain.
  • Effect of the curve on a patient's appearance.
  • Risk of cardiopulmonary or neurological problems.

If your child has mild curvature that is not expected to worsen or cause any issues with daily activities, your doctor will likely recommend observation.

Braces

If your child has a curve that is between 60 and 80 degrees and your child has not finished growing, a back brace may be recommended. The brace should be worn 24 hours a day until the patient has finished growing. Most patients will wear the brace for 18 months or more.

Physical therapy

Your child’s doctor will likely recommend physical therapy to strengthen the back and stomach muscles as well as stretching exercises that can help the hamstrings and pectoral muscles. In most cases, physical therapy is used in combination with braces.

Surgery

If your child is not improving after six months of nonsurgical treatments such as bracing and physical therapy, your child’s doctor may recommend surgery in the following cases:

  • The curve continues to get bigger (over 70 degrees) and is causing moderate to severe pain.
  • There is a risk of neurological issues associated with the condition.

Surgery to correct Scheuermann's Disease consists of fusing the vertebrae. The surgery is a significant operation. Your doctor will discuss the benefits and risks of the procedure before deciding to perform it.

When to Seek Care

While serious issues associated with Scheuermann's Disease are rare, the disease can progress to the point where the spinal cord or internal organs are harmed. If your child has symptoms of Scheuermann's Diseases, schedule an appointment with your doctor to discuss treatment options.

Next Steps

If you suspect your child has Scheuermann's Disease, schedule an appointment with your primary care doctor. Your doctor may refer you to an orthopedic specialist if your case is moderate to severe. During and after treatment, follow your doctor’s instructions carefully to ensure the recovery process goes smoothly. If your symptoms are worsening, call your doctor right away for instructions.