Management of Scheuermann’s Kyphosis

Abstract

There are 12 thoracic and five lumbar vertebrae. The thoracic and lumbar spine starts from the upper border of the T1 vertebra and finishes at the lower border of L5. The thoracic vertebrae are all of a reasonably uniform shape with long caudally directed spinous processes. The facet joints are orientated in a circumference where the centre is the vertebral body allowing rotation but not flexion or extension. Scheuermann's disease was first described in 1921 as a painful, fixed, dorsal kyphosis consisting of wedged vertebrae, with disturbances of the vertebral endplates, occurring in adolescents. Sorensen later proposed the now widely accepted radiographic criteria of three adjacent wedged vertebrae, angled by at least 5°. For some authors, one wedged vertebra is sufficient to conclude a diagnosis of Scheuermann's disease if associated with irregular vertebral endplates(3). The management of scheurmann kyphosis is controversial. Some think that no treatment is required, as the disease usually follows a benign course with few adverse sequelae. Others believe that treatment in those who are skeletally immature will prevent future excessive deformity and pain. For decades, there has been a lot of controversy surrounding treatment options. For less extreme cases, manual medicine, physical therapy and/or back braces can help reverse or stop the kyphosis before it does become severe. corrective osteotomies are used to treat sagittal and coronal imbalances