Procedures

Kyphosis Correction

Scheuermann’s disease is a developmental disorder that causes patients to become stooped forward with a bent-over posture as a result of excessive kyphosis of the thoracic spine. The condition affects between 0.5% and 8% of the general population and is more common in boys than in girls.

DIAGNOSIS

Differentiating Scheuermann’s kyphosis from postural kyphosis requires a physical examination and radiographs of the spine. The physical examination determines where the apex of the curve is located, where the patient is experiencing back pain, how flexible the curve is and whether or not there are any other related findings. Radiographs look for the presence of at least 5 degrees of vertebral body wedging over 3 adjacent levels (currently the most commonly accepted criteria for radiographic diagnosis). They also determine more precisely the relative percent correction possible by attempting to reverse the kyphotic curve with a bolster or pillow placed at its apex while the patient is lying down.

TREATMENT

The treatment of Scheuermann’s disease depends upon several factors, including the age of the patient, the severity of the curve, the presence or absence of back pain and whether or not the lungs are developing and functioning normally.

If a patient is young and has a mild curve, no back pain and normal pulmonary function, then continued observation by a doctor is usually prescribed, with repeat clinical examinations and radiographs at regular intervals (often every year).

Patients with kyphosis are often advised to participate in activities that strengthen the muscles supporting the spine. Stretching the hamstrings and improving cardiovascular fitness are also recommended. This type of therapy is considered an important part of ensuring the curve stays as flexible as possible to prevent further progression.

Other forms of treatment, including bracing and surgery, are considered when there is a rapid increase in the size of the curve, worsening of the vertebrae body wedging, back pain that will not improve with conservative measures or difficulties with pulmonary function related to the kyphotic deformity. The decision about when and how to brace the spine of a patient with Scheuermann’s disease, or perform surgery, depends on the individual patient.