Scheuermann Disease (Juvenile kyphosis)

FACTS

Typical: anterior wedging of at least 5˚ of ≥3 adjacent thoracic VB
  • 1-8% of population, M > F
  • pathophysiology: disproportionate posterior VB growth vs. anterior VF
 
Atypical (Lumbar)
  • mechanism: flexion and extension
 
 

HPI

  • pain
  • cosmetic deformity

PHYSICAL EXAM

IMAGING

Typical (thoracic) - Sorenson criteria
* 3 contiguous VB with 5˚ of kyphotic deformity (anterior wedge) per level
Associated findings:
  • endplate irregularities
  • anterior disc space narrowing of disc space
  • Schmorl’s nodes (see below)
  • scoliosis in≈ 25%
  • spondylolysis (p. 1146) in 50%55: likely due to the increased lumbar lordosis that compensates for
    the increased thoracic kyphosis
 
A/P
  • SSXR for baseline
  • MRI only to evaluate thoracic disc herniations if concerned
  • Bracing for young asymptomatic patients with deformity
  • Conservative: NSAIDs, PT
  • Surgical treatment generally indicated for severe pain or kyphosis / neuro deficits
    • correction deformity (posterior fusion w/ multiple osteotomies)

Schmorl’s Nodes

notion image
notion image