This is the last in our series of articles on osteochondroses.
There is a group of conditions that affect bones in the growing child called osteochondroses. Due to a number of reasons including altered blood supply, the bone becomes soft and may become deformed. After a few years, the bone will harden again, in its new (often deformed) shape. Scheuermann’s disease is a form of juvenile osteochondritis and is the most common cause of thoracic backache and postural abnormality in adolescents.
What is the thoracic spine?
1. Cervical spine (neck)
2. Thoracic Spine (upper back)
3. Lumbar Spine (lower back)
While Scheuermann’s disease typically occurs in the thoracic spine, it is also seen in the thoraco-lumbar region. It involves a deformity of at least 4 vertebrae in the thoracic spine. As the condition worsens the vertebrae become wedge-shaped and result in an exaggerated curve of the upper back known as kyphosis. Scheuermann’s is a self-limiting skeletal disorder of childhood. The exact cause is still unknown.
Signs and Symptoms:
- Mild back pain
- Rounded back appearance
- Tenderness & stiffness in the spine
- Difficulty breathing (if severe)
Making the Diagnosis
If these symptoms are recognised in a child, they must be referred to a doctor. The doctor will conduct a physical examination to confirm the rounding (kyphosis) of the back and to check for any neurological changes below the curve. The doctor will also order other tests including x-ray, lung function tests and MRI.
In most cases, treatment for Scheuermann’s disease is conservative as the disease is self-limiting after growth is complete. Treatment, therefore, aims to provide symptomatic relief and also supportive means to limit the deformity while the bones are still growing. Methods using specialised physical therapy and/or back braces have been shown to reduce pain and decrease kyphosis in less severe cases. Surgery is considered where conservative treatment has failed or in very severe kyphosis. The procedure often done is a spinal fusion and hardware instrumentation (i.e. rods and screws).
Adolescents with Scheuermann’s disease often do well even if surgery is required. Remember that the disease is self limiting so it stops when the child stops growing. Encourage your child to be healthy and active – we all need to live with zest and spirit!
References available on request.
Yours in health and exercises