Scheuermann's disease (Scheuermann's disease) is a relatively common spinal disease, which in particular in childhood and adolescence occurs. Characteristic for Scheuermann's disease is the Formation of a hunchback in the thoracic spine area. While the healthy thoracic spine is only slightly curved backwards, this kyphosis (curvature) is more pronounced in Scheuermann's disease. Only in very rare cases does Scheuermann's disease also occur in the area of the lumbar spine. Can lead to a flat back in this section of the spine due to pathologically developed kyphosis. What is Scheuermann's disease. How it develops?For the development of Scheuermann's disease there are Various explanations. However, the etiology has not been precisely researched to date. It is amed that Scheuermann's disease on the one hand is due to congenital or. endogenous factors develops. On the other hand it is metabolic diseases or mechanical stresses on the spine caused.
The growth disorder Occurs in adolescence and affects the base and ceiling plates of the thoracic and/or lumbar spine. Here it comes to an increased prere on vertebral bodies and intervertebral discs. In the front, the vertebrae are further depressed, so that the increased Hunchback formation adjusts.
In addition to Scheuermann's disease, a so-called Scheuermann's scoliosis frequently develops. More rarely, the disease also leads to premature wear and tear of the intervertebral discs. In the second or third decade of life, this can under certain circumstances lead to a Stiffening of the spine lead. To compensate for the limited mobility of the spine, Scheuermann's disease can thus cause a Hollow back arise.
Disease Name and Synonyms for Scheuermann's Disease
Scheuermann's disease was named after Dr. Holger W. Scheuermann (1877- 1960), who described the disease in 1921. Morbus is the Latin word for disease. Since Scheuermann's disease is most common in children and adolescents, the disease is often referred to as
– adolescent kyphosis, – juvenile osteochondrosis or – juvenile kyphosis
denotes. Other synonyms are
– Scheuermann's disease, – Scheuermann's disease and – aseptic osteochondrosis.
About the frequency (epidemiology) of Scheuermann's disease
Scheuermann's disease is one of the most common diseases of the spine. boys are affected more often than girls in a ratio of two to one. Scheuermann's disease occurs in the late childhood phase. early phase of adolescence on. About 1 to 8 percent of the population are on average affected by Scheuermann's disease. The symptoms and effects of the disease do not show up at all in the beginning.
Causes of Scheuermann's disease
In late childhood and in the adolescent phase, there are often Imbalance between load and capacity of the spine. Because children with ca. eight years of age, the patient does not yet have a very well developed musculature to protect the spine, in particular the thoracic spine. Especially against the background of a lack of movement of many children, the musculature is often too weak to cope with the load of the daily school routine etc.. to compensate. One overloading of the thoracic spine is the consequence and can favor the occurrence of the Morbus Scheuermann.
Furthermore, it is amed that also Metabolic diseases or endogenous factors such as genetic factors can cause Scheuermann's disease. Also hormonal changes (endogenous factor) can play a role in this. Accordingly, Scheuermann's disease has various causes; however, the etiology is not yet sufficiently researched. However, it is amed that the various causes can influence and reinforce each other.
Scheuermann's disease is nowadays mostly assigned to the so-called Osteochondysplasia assigned. This is understood to mean disorders of growth and development of bones and cartilage. In the past, the disease was mainly classified as an aseptic osteochondrosis, which is why in rare cases it is also referred to as aseptic osteochondrosis.
There is a consensus that genetic factors play a role. One suspects autosomal dominant heredity. Furthermore a connection between Morbus Scheuermann. A general growth retardation of the skeleton.
Symptoms of Scheuermann's disease
In the majority of affected patients, Scheuermann's disease progresses during the period of growth disturbance, i.e in childhood and adolescence, without pain or other symptoms. Only a small group of patients suffers from back pain. complaints In most cases, back pain only occurs as a result of overloading due to changes and degeneration of the spinal column in adulthood, especially between the 20. and 30. age, to. The disease is therefore often detected only in adulthood.
The growth disturbance of the base and ceiling plates of the thoracic spine also affects the cervical and lumbar spine with their associated intervertebral discs and cartilage, etc. overloaded. As a consequence, corresponding pain occurs. In addition, a Hollow back to compensate for the reduction in mobility of the thoracic spine due to hypermobility of the lumbar spine. Due to the changes in the thoracic or lumbar spine, in addition to Back pain also increased tension in the neck and other Muscle tension occur.
Thus affected patients often suffer from restricted mobility and stiffness in the corresponding sections of the spine and degenerative changes in the spine and intervertebral discs. Since Scheuermann's disease is a growth disease, the pathological growth of Scheuermann's disease also comes to an end at about 18 years of age.
Due to an progressive hunchback and hollow back formation there can also be strong local discomfort. This includes above all radiating pain into the arms and legs. Severe pain due to muscle tension in the back as well as pain of the ligaments and joints can be caused by Scheuermann's disease at the end of growth, rarely earlier.
Diagnosis of Scheuermann's disease
Since Scheuermann's disease is a growth disorder of the spine in adolescence, but the symptoms do not manifest themselves until adulthood, Scheuermann's disease is often an incidental finding. However, in the case of the late sequelae, which only occur in adulthood, one no longer speaks of Scheuermann's disease, since the pathological growth sets in when the patient stops growing. In adulthood there is then talk of condition after Scheuermann's disease.
Affected patients usually also exhibit symptoms such as hunchback, which can be seen with the naked eye. A detailed anamnesis discussion between doctor and patient is always important for a differential diagnosis or the exclusion of other diseases. Furthermore, a physical examination, The patient's mobility, for example, is checked and a first impression of the severity of a hunchback or hollow back can be gained.
After the physical examination the imaging diagnostics. To determine the severity of the deformity, an image of the entire spine should be taken. By means of an image from the side, the extent of the deformity of the vertebral bodies can also be determined. With the help of Computer tomography (CT) and the magnetic resonance imaging (MRI) only in a few cases additional information is provided. However, in the assessment of early forms of Scheuermann's disease, these imaging techniques can be of benefit. Especially when the X-rays If the vertebral bodies do not show any deformity of the bones, a damage of the soft ties can be suspected. If there is damage to the intervertebral discs or other soft ties, MRI is also the diagnostic tool of choice.
Treatment of Scheuermann's disease
The therapy of Scheuermann's disease resp. of the condition after Scheuermann's disease depends on the extent of the growth disturbance and the late consequences of the disease. The severity of the disease is important for the therapy. This can be determined by the doctor on the basis of the X-ray images. Determining a specific form of an angle measurement method.
If the patient is still growing and the growth disturbance is therefore still ongoing, the following can be physiotherapeutic exercises to relieve prere, prevent further progression, provided that Scheuermann's disease was detected early enough. A pronounced Scheuermann's disease can also be treated for a short time with the help of a corsets or. a Orthosis be treated.
In addition to the conservative treatment methods, there are also surgical procedure available. However only in the case of very severe late sequelae In the case of Scheuermann's disease, surgical treatment methods can be considered.
As a rule, however, Scheuermann's disease remains undetected, so that the various treatment options are not used. However, in the case of complaints, patients are usually advised to be treated by exercise, sports and a physiotherapy strengthen, relieve and relax the back muscles and prevent the progression of restricted movement.
Such training, be it against a progression of Scheuermann's disease, in the case of symptoms of the condition after Scheuermann's disease or in the case of other spinal diseases that are not signs of wear and tear, includes targeted training, for example, from
– strengthening exercises, – swimming, – relaxation exercises and – back exercises.
In most cases, it is possible that those affected by Scheuermann's disease do not have to forfeit any loss of quality of life, as long as they follow a proper lifestyle.
Prevention of Scheuermann's disease
Since the causes of Scheuermann's disease are still largely unexplored, it is difficult to prevent the disease through a certain lifestyle. The main goal is to live with the diagnosed Scheuermann's disease as symptom-free as possible. This is made possible by appropriate treatment measures, such as physiotherapy, sports, exercise and possibly the wearing of a supportive corset.
The earlier Scheuermann's disease is diagnosed and treated, the lower the risk of suffering from late complications in adulthood. To determine the symptoms and progression of Scheuermann's disease during growth to contain the disease, exercise, sport and physiotherapy adapted to the physiotherapeutic exercises necessary. continued at home. Be integrated into your everyday life.
Medical experts suspect that the imbalance between load and load-bearing capacity of the spine of children and adolescents may also play a role in the development of Scheuermann's disease. Therefore, it is important that children and adolescents in particular (also to prevent other diseases of the back and spine) Strengthen the back, trunk and abdominal muscles through regular exercise that is easy on the spine. Because a well-developed musculature protects the bones, cartilage and intervertebral discs from damage and injury. The most important thing, therefore, is that both sick and healthy children and adolescents exercise in order to remain mobile and upright and to prevent the onset of symptoms in adulthood.