Introduction
Scheuermann’s disease, a growth disorder occurring in adolescence at the base and top of the vertebral bodies of the thoracic and/or lumbar spine with increased kyphosis or reduced lordosis (decrease or increase in the physiological vibration of the spinal column). At least three adjacent vertebral bodies must be affected, each of which has a wedge vertebra angle of at least 5 degrees. The name Scheuermann’s disease goes back to the Danish radiologist and first describer of this disease H. W. Scheuermann (1877-1960). There are many synnyms, including juvenile kyphosis, adolescent kyphosis, postural kyphosis and juvenile hunchback.
Cause
The cause of M. Scheuermann is not known. Mechanical and genetic factors with a reduced capacity of the vertebral body, anomalies of the vertebral rims, intervertebral disc tissue entering the vertebral bodies, and vitamin deficiency syndromes, etc. may play a role.
The X-ray image shows a wedge-shaped vertebra formation and so-called Schmorl’s nodules, which represent intervertebral disc tissue that has penetrated the vertebral body. Ultimately, an imbalance in the growth of the anterior and posterior parts of the vertebral body occurs, which results in the formation of wedge vertebrae. Clinical and radiological changes can occur from the age of 11 years.
The disease-typical changes in the vertebral bodies are stabilized at the end of growth. Secondary phenomena due to kyphotic spinal malpositioning can also appear later. In particular, the practice of strenuous sports during adolescence can promote the development of Scheuermann’s disease.
Performance gymnasts are particularly worthy of mention here. A connective tissue disorder (collagen) can rarely be the cause of a Scheuermann’s disease. The occurrence of this disorder, especially during puberty, allows the conclusion to be drawn that the disease is hormonally involved. Many bone growth disorders, such as Perthes disease, occur during puberty.
Epidemiology
Scheuermann’s disease is the most frequent spinal column change in the growth age. Not every disease is necessarily accompanied by symptoms or complaints. Scheuermann’s disease can be detected on X-rays in about 20 – 30% of all young people, only a small proportion of whom develop symptoms.
4 – 6% of the total population are affected. The sex ratio is male to female = 2:1. The typical age of onset of the disease is between 11 and 13 years. In most cases the Scheuermann’s disease affects the thoracic spine, less frequently the lumbar spine. If the disease also affects the thoracolumbar spine, it is referred to as a thoracolumbar Scheuermann.
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