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Scheuermann’s disease


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Scheuermann’s disease occurs clinically at the age of 8 – 12 years as faulty posture with kyphosis which aggravates and becomes stiff and irreducible during growth.

Scheuermann believes that this disease is due to the aseptic necrosis of the vertebral marginal border. Schmorl and Yunghans assign it to the presence of vertebral intraspongious hernias, due to the weakening of the resistance of the cartilaginous plate.

  • irregularities of the vertebral plateaus;
  • impressions of the disc on the vertebral plateaus (Schmorl nodes) in the anterior 1/3;
  • cuneiformizations of the vertebral bodies leading to juvenile thoracic kyphosis;
  • subsequently structural, progressively evolving towards aggravation and then towards stiffness, when the growth stops.

To redress the trunk, the kyphotic patient will create a compensatory lordosis predominantly lumbar

At the adult age, the existing lesions favor the occurrence of secondary arthrosis..

The disc incarcerated in the prints of the vertebral plateaus loses its functional value. .

The ligaments become sclerotic and the anterior osteophytes follow the ligament trajectories

The disease becomes painful in adolescence and in the young adult (sequela stage), the lesions accentuate with anterior discarthrosis and upper lumbar retrolisthesis.

The treatment initially consists in kinetic therapy, , subsequently it becomes a corrective treatment by gypsum devices or by orthesis, and finally it is surgical treatment (aggravation of curvature, accentuation of vertebral lesions and of cuneiformization of vertebrae from the curvature apex, pain caused by severe thoracic kyphosis that does not fade under medical and kinetic treatment; alteration of the breathing function related to the vertebral deformation).

Interdictions in Scheuermann’s disease:

  • Maintain fixed positions for long periods of time;
  • Avoid cold;
  • Lifting weights
  • Physical and sports activities;
  • Losing weight or maintaining weight;
  • Avoid constipation;
  • Avoid flu

 

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