Scheuremann's kyphosis is a structural kyphosis that typically develops during adolescence, causing the kyphotic spine to become rigid, and sometimes progresses into adulthood. In the spines of these patients, the front sections of the vertebrae grow more slowly than the back sections. Instead of normal and rectangular with ideal alignment, the vertebrae are wedge-shaped and cause misalignment. The abnormal kyphosis is best viewed from the side in the forward-bending position where a sharp, angular abnormal kyphosis is clearly visible.
Symptoms & Imaging Evaluation
- Symptoms include poor posture and back pain.
- Standing x-rays are usually the best way to evaluate and monitor Scheuremann's kyphosis.
- Non-steroidal anti-inflammatory drugs (NSAIDS) like ibuprofen or acetaminophen
- Physical therapy & exercise to strengthen muscles and ultimately help alleviate pain
If kyphosis has become severe (greater than 80 - 90°) and causes frequent back pain, surgical treatment may be recommended. Surgery provides significant correction without the need for postoperative bracing. Pedicle screws are placed, 2 per vertebra, and connected with 2 rods. This process promotes gentle straightening of the spine. Most surgeries are performed from the back; however, some physicians recommend additional surgery on the front of the spine. Patients are usually able to return to normal daily activities within 4 to 6 months following surgery.
Moderately flexible curves often straighten simply from lying face down; however, rigid curves may require surgical intervention. The Smith-Peterson osteotomy involves cutting the bone in the back of the spine that connect the facet joints. The removal of this bone and the joints allows the spine to move backwards into extension or more of an upright position. This type of osteotomy is commonly performed during the surgical treatment of Schuermann's kyphosis.