Scheurermann’s disease


Scheuermann’s disease is a self-limiting skeletal disorder of childhood. It is also known as Sherman's Disease (since some people have difficulties spelling Scheuermann) and Scheuermann’s kyphosis, since it results in kyphosis. It is named for Holger Werfel Scheuermann.[1][2][3] It is more well characterized for the thoracic spine than for the lumbar spine.[4][5]


The cause is not currently known, and the condition appears to be multifactorial.[6] Several candidate genes (such as COL1A2) have been proposed and excluded.[7]


the normal curvature of the thoracic spine is between 20 and 50 degrees. A curvature of more than 50 degrees, where the spine has three contiguous vertebral bodies that have wedging of 5 degrees or more, constitutes Scheuermann’s disease. Postural roundback in adolescents is most often caused by posture and not by structural changes to the spine. Postural roundback can be easily distinguished from Scheuermann’s kyphosis by the fact that the deformity goes away when the patient lies down. Typically, patients with true Scheuermann’s kyphosis need to sleep on two or three pillows at night to stay comfortable because there deformity remains when they lie down.


There are many ways to treat Scheuermann’s kyphosis. For less extreme cases, manual medicine, physical therapy and/or back braces can help reverse or stop the kyphosis before it does become severe. Severe or extreme cases sometimes may be treated through an extensive surgical procedure. Chiropractic has also been shown to be effective in the treatment of Scheuermann's kyphosis and other scoliotic diseases. [8] As always, surgical intervention should be used as a last resort once conservative treatment fails or the patient's health is in imminent danger as any surgical procedure is not without risk; however, the chances of complication are relatively low. The surgical procedure partially entails entering two titanium rods, each roughly one and a half feet long, into the back on either side of the spine. Eight titanium screws and hardware are drilled through the bone and secures them in place onto either side of the spine. On the internal-facing side of the spine, ligaments (which can be too short, pulling the spine into the general shape of kyphosis) must be surgically cut or released, not only stopping part of the cause of the kyphosis, but also allowing the titanium rods to pull the spine into a more natural position. Normally, the damaged discs between the troubled vertebrae (wedged vertebrae) are removed and replaced with cartilage from the hip or other parts of the vertebrae, which once healed or 'fused' will solidify. The titanium instrumentation holds everything in place during healing and is not necessary once fusion completes. Recovery begins in the hospital and depending on whether the operation is one or two stage the patient can expect to be in hospital for minimum of a week possibly longer depending on recovery. They will then often be required to wear a brace for several months to ensure the spine heals correctly leaving the patient with the correct posture. The titanium instrumentation can stay in the body permanently, or be removed years later. Patients undergoing surgery for Scheuermann's disease often need physical therapy to manage pain and mobility, patients will struggle with mobility particularly when completing repetitive tasks such as lifting, carrying or exercising this will often last for much or all of their lives.