II. Epidemiology
- Most common structural kyphosis in teenagers,with typical onset age 10-12 years old (as early as 8 years old)
III. Precautions
- Scheuermann's Kyphosis is often misdiagnosed as poor Posture (postural kyphosis)
IV. Pathophysiology
- Osteochondrosis affecting the Vertebral epiphyseal Growth Plates
- Vertebral end plate disorder results in Vertebral body wedging
- With growth spurt, kyphosis increases
V. Symptoms
- Stooped Posture
- Upper back pain
- Gradual onset
- Worse at end of day
- Relieved with rest
VI. Signs
- Rigid kyphosis (humpback deformity) that does not improve with back extension or lying supine
VII. Diagnosis
VIII. Differential Diagnosis
- Congenital kyphosis (formation or segmentation failure in development)
- Neuromuscular kyphosis (Cerebral Palsy, Myelomeningocele, Syringomyelia, polio)
- Postural kyphosis
IX. Imaging
X. Management
- Physical Therapy
- Bracing indications
- Kyphosis 55-80 degrees before skeletal maturity
- Bracing is poorly tolerated and rarely used in U.S.
- Surgery indications
- Kyphosis >80 degrees in Thoracic Spine
- Kyphosis >65 degrees in thoracolumbar spine
- Progressive or refractory course resulting in pain, neurologic deficit or balance concerns
- Restrictive Lung Disease related symptoms and signs
XI. Course
- Progression is most pronounced during growth spurt and then slows after reaching skeletal maturity