Orthopedics Book


Scheuermann's Kyphosis

Aka: Scheuermann's Kyphosis, Scheuermann's Disease, Scheuermann Kyphosis
  1. See Also
    1. Pediatric Back Pain
  2. Epidemiology
    1. Most common structural kyphosis in teenagers,with typical onset age 10-12 years old (as early as 8 years old)
  3. Pitfalls
    1. Often misdiagnosed as poor Posture (postural kyphosis)
  4. Pathophysiology
    1. Osteochondrosis affecting the Vertebral epiphyseal Growth Plates
    2. Vertebral end plate disorder results in Vertebral body wedging
    3. With growth spurt, kyphosis increases
  5. Symptoms
    1. Stooped Posture
    2. Upper back pain
      1. Gradual onset
      2. Worse at end of day
      3. Relieved with rest
  6. Signs
    1. Rigid kyphosis (humpback deformity) that does not improve with back extension or lying supine
  7. Diagnosis
    1. Three or more adjacent Vertebrae wedged >5 degrees and thoracic disc space narrowing
      1. Draw lines from parallel to the top and bottom of the Vertebral bodies extended anteriorly
      2. Measure wedging angle at the point at which the 2 lines intersect
        1. Lines do not intersect in a normal, non-wedged Vertebrae
  8. Differential Diagnosis
    1. Congenital kyphosis (formation or segmentation failure in development)
    2. Neuromuscular kyphosis (Cerebral Palsy, Myelomeningocele, Syringomyelia, polio)
    3. Postural kyphosis
  9. Imaging
    1. Thoracolumbar Xray
      1. Lateral: Diagnosis requires 5 degrees or more of wedging in at least 3 adjacent Vertebrae
      2. Also evaluate for Scoliosis and disc space narrowing
    2. Thoracolumbar MRI
      1. Indicated in severe symptoms and non-diagnostic XRay
  10. Management
    1. Physical Therapy
    2. Bracing indications
      1. Kyphosis 55-80 degrees before skeletal maturity
    3. Surgery indications
      1. Kyphosis >80 degrees in Thoracic Spine
      2. Kyphosis >65 degrees in thoracolumbar spine
      3. Progressive or refractory course resulting in pain, neurologic deficit or balance concerns
      4. Restrictive Lung Disease related symptoms and signs
  11. Course
    1. Progression is most pronounced during growth spurt and then slows after reaching skeletal maturity
  12. References
    1. Achar (2020) Am Fam Physician 102(1):19-28 [PubMed]
    2. Lowe (2007) Neurosurg Clin N Am 18(2): 305-15 [PubMed]

Scheuermann's Disease (C0036310)

Definition (MSH) A type of juvenile osteochondrosis affecting the fibrocartilaginous disc (INTERVERTEBRAL DISC) in the thoracic or thoracolumbar region of the SPINE. It is characterized by a forward concave SPINAL CURVATURE or KYPHOSIS.
Definition (MSHCZE) Onemocnění páteře vznikající vobdobí adolescence, někdy s rodinným výskytem. Projevuje se bolestí zad,změnami na obratlech ameziobratlových ploténkách, zejm. v hrudní páteři. Na rtg je patrná kyfóza hrudní páteře, deformace hrudních obratlů způsobená aseptickou nekrózou, typické jsou tzv. Schmorlovy uzly. Onemocnění se manifestuje převážně ve věku 10 až 13 let. Pohyb je omezen v oblasti středních a dolních hrudních obratlů, trup je lehce nakloněn dopředu, vsedě nastupuje rychle únava a bolesti zad. Při vhodné životosprávě a rehabilitaci je prognóza příznivá. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ )
Definition (NCI) A disorder characterized by osteochondrosis of the vertebral epiphyses in childhood.
Concepts Disease or Syndrome (T047)
MSH D012544
ICD9 732.0
ICD10 M42.0, M42.00, M42.09
SnomedCT 203361005, 203415006, 203362003, 156816000, 203364002, 53406005
English Scheuermanns Disease, Juv osteochondrosis of spine, Juvenile osteochondritis of the spine NOS, Juvenile osteochondritis of the spine, unspecified, Juvenile spine osteochond.unsp, Juvenile spine osteochondr.NOS, SCHEUERMANN DISEASE, SPINAL OSTEOCHONDROSIS, SCHEUERMANN JUVENILE KYPHOSIS, Scheuermann's Disease, SCHUERMANN'S DISEASE, SCHEUERMANNS DIS, SCHEUERMANN DIS, Juvenile osteochond.of spine, juvenile osteochondrosis of spine, juvenile osteochondrosis of spine (diagnosis), vertebral epiphysitis, juvenile osteochondrosis of vertebral epiphyses (diagnosis), juvenile osteochondrosis of vertebral epiphyses, Kyphoses, Juvenile, Spine Juvenile Osteochondrosis, Kyphosis, Scheuermann's, Scheuermann's Kyphoses, Scheuermann Kyphosis, Scheuermann Kyphoses, Spine Juvenile Osteochondroses, Kyphoses, Scheuermann, Juvenile Kyphosis, Scheuermann Disease, Kyphosis, Scheuermann, Scheuermann's Kyphosis, Juvenile Kyphoses, Kyphoses, Scheuermann's, Scheuermanns Kyphosis, Kyphosis, Juvenile, Juvenile Osteochondrosis of Spine, Schuermann's disease, Juv osteochondros spine, Kyphoses, Adolescent, Kyphosis, Adolescent, Adolescent Kyphosis, Adolescent Kyphoses, Calve's Disease, Calvé's disease, Scheuermann Disease [Disease/Finding], Juvenile osteochondrosis of spine, site unspecified, disease scheuermann's, scheuermann's kyphosis, juvenile kyphosis, scheuermann disease, scheuermanns disease, Disease;Scheuermann, diseases scheuermanns, scheuermann's disease, schuermann's disease, scheurmann's disease, Kyphoses, Scheuermann Juvenile, Kyphosis, Scheuermann Juvenile, Scheuermann Juvenile Kyphosis, Juvenile Kyphoses, Scheuermann, Juvenile Kyphosis, Scheuermann, Scheuermann Juvenile Kyphoses, Juvenile osteochondritis of the spine, unspecified (disorder), Juvenile osteochondritis of the spine (disorder), Juvenile osteochondritis of the spine NOS (disorder), Juvenile osteochondrosis of spine, Scheuermann's disease, Juvenile kyphosis, Juvenile osteochondrosis of vertebral epiphyses, Kyphosis dorsalis juvenilis, Scheuermann's kyphosis, Vertebral epiphysitis, Osteochondritis of the spine, Juvenile osteochondritis of the spine, Juvenile osteochondrosis of spine (disorder), Scheuermann; osteochondrosis, Scheuermann, epiphyseal; plates, vertebral, juvenile osteochondrosis, Calvé, osteochondrosis; Scheuermann, osteochondrosis; juvenile, vertebra, osteochondrosis; spine or vertebra, juvenile, spine or vertebra; osteochondrosis, juvenile, spine; osteochondrosis, juvenile, vertebra; osteochondrosis epiphyseal plates, juvenile, vertebra; osteochondrosis, juvenile, Juvenile osteochondrosis of spine, NOS, Juvenile osteochondrosis of marginal or vertebral ephiphysis, Juvenile osteochondrosis of Scheurermann, Juvenile osteochondrosis of spine NOS, Scheuermann disease
French EPIPHYSITE VERTEBRALE, Ostéochondrose juvénile du rachis, Cyphose douloureuse des adolescents, Dystrophie rachidienne de croissance, Maladie de Scheuermann, Ostéochondrose vertébrale de croissance, Épiphysite vertébrale des adolescents, Épiphysite vertébrale juvénile, Épiphysite vertébrale douloureuse de l'adolescence
Dutch ziekte van Scheuermann, juveniele osteochondrose van wervelkolom, Scheuermann; osteochondrose, epifysair; schijven wervel, juveniele osteochondrose, osteochondrose; Scheuermann, osteochondrose; juveniel, wervel, osteochondrose; wervel{kolom}, juveniel, wervel; osteochondrose epifysairschijven, juveniel, wervel; osteochondrose, juveniel, wervelkolom; osteochondrose, juveniel, wervel{kolom}; osteochondrose, juveniel, Juveniele osteochondrose van wervelkolom, Osteochondropathia juvenilis deformans, Ziekte van Scheuermann
German juvenile Osteochondrose der Wirbelsaeule, Juvenile Osteochondrose der Wirbelsaeule, Adoleszentenkyphose, Osteochondrosis deformans juvenilis vertebralis, Scheuermann-Krankheit
Italian Osteocondrosi giovanile della colonna vertebrale, Malattia di Schuermann, Malattia di Scheuermann
Portuguese Osteocondrose juvenil da coluna vertebral, DOENCA DE SCHUERMANN, Doença de Scheuermann
Spanish Osteocondrosis juvenil de la columna vertebral, Enfermedad de Schuermann, osteocondritis juvenil de la columna vertebral, no especificada (trastorno), osteocondritis juvenil de la columna vertebral, no especificada, osteocondritis juvenil de la columna vertebral, SAI, osteocondritis juvenil de la columna vertebral, SAI (trastorno), cifosis de Scheuermann, cifosis dorsal juvenil, cifosis juvenil, enfermedad de Scheuermann, epifisitis vertebral, osteocondrosis juvenil de las epífisis vertebrales, osteocondrosis vertebral juvenil (trastorno), osteocondrosis vertebral juvenil, Enfermedad de Scheuermann
Japanese 若年性脊椎骨端症, ショイエルマンビョウ, ジャクネンセイセキツイコッタンショウ, Scheuermann病, ショイエルマン病, 脊椎骨軟骨炎, 若年後弯, 若年性円背, 若年性変形性脊椎症, 若年性脊柱後弯症, 限局性脊椎骨軟骨炎, 青年性亀背, 青年性後弯, 青年性脊椎後弯
Swedish Scheuermanns sjukdom
Czech Scheuermannova nemoc, Juvenilní osteochondróza páteře, juvenilní kyfóza, juvenilní osteochondróza páteře, Scheuermannova choroba, Scheuermannova kyfóza, adolescentní kyfóza, osteochondrosis deformans juvenilis dorsi
Finnish Scheuermannin tauti
Korean 척추의 청소년성 골연골증
Polish Choroba Scheuermanna, Kifoza młodzieńcza
Hungarian Scheuermann-betegség, Fiatalkori gerinc osteochondrosis, Scheuermann-syndroma
Norwegian Osteochondrosis deformans juvenilis vertebralis, Scheuermann-sykdom, Morbus Scheuermann, Scheuermanns sykdom, Scheuermann-kyfose, Juveil osetokondrose i ryggsøylsen
Derived from the NIH UMLS (Unified Medical Language System)

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