Scheuermann's kyphosis is a "developmental" type of kyphosis. This means that it happens while your body is growing. Normal vertebrae are rectangular-shaped and stacked on top of one another like building blocks, with a soft cushion disc between each one. In Scheuermann's Kyphosis, the front of the vertebrae wedge forward and closer together in a triangular shape. This causes the spine to curve forward more than normal. Scheuermann's Kyphosis develops in adolescents while their bones are still growing. It happens to about 1% of people in this age group, and happens in boys as often as in girls.
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What Causes Scheuermann's Kyphosis
The cause of Scheuermann's kyphosis is not yet known, but there are many possible theories about how it develops. Scheuermann, a Danish radiologist, proposed that the problem started because cartilage in the spine died from a lack of blood supply. He suggested that this interrupted bone growth during development, leading to wedging of the affected vertebrae.
Most researchers think that some sort of damage to the growth area of the vertebrae starts the process. This damage may be caused by a vertebral disorder during the rapid growth spurts of adolescence. Many spine specialists also believe that a problem with the mechanics of the spine (the way it is put together and functions) plays a part in Scheuermann's kyphosis. Others suggest mild osteoporosis could contribute to the deformity. Muscle abnormalities have also been considered as a possible cause. And there does seem to be a high genetic predisposition to this disease - meaning that it tends to run in families.
Scheuermann originally noticed this spinal deformity in agriculture workers who were frequently hunched or bent over. This led to the question of whether poor posture could lead to extra kyphosis. While this is a logical question, the connection between posture and this deformity has never been confirmed. However, poor posture has been shown to play a role in making the problem worse. Therefore, correcting postural problems can sometimes help improve abnormal kyphosis.
Symptoms of Scheuermann's Kyphosis
Symptoms of Scheuermann's Kyphosis generally develop around puberty, between the ages of 10 and 15 years old. It is difficult to know exactly when the problem begins because X-rays do not show the changes until the child reaches 10 or 11 years old. Scheuermann's Kyphosis is often discovered when parents notice their child has poor posture or is slouching. The child might experience pain and fatigue in the mid back. The pain is rarely disabling or severe at this point, unless the deformity is severe.
Scheuermann's Kyphosis is usually slow to develop. When it progresses to the point the rounded curve becomes noticeable, a concerned parent or teacher will suggest a doctor visit. This is what leads most children to get medical help - not the presence of pain. By comparison, adults who develop Scheuermann's Kyphosis early in life tend to seek help because pain from the deformity becomes unbearable.
A rigid curve in the spine is common with Scheuermann's Kyphosis. The curve gets worse with bending over and only partially corrects when standing up straight. Pain typically increases with time and severity of the deformity. About one-third of people with Scheuermann's Kyphosis also have scoliosis (sko-lee-oh-sis). Scoliosis is another type of spinal deformity that usually occurs in teenagers. Looking at an X-ray from the front, scoliosis curves side to side, like an "S" rather than a straight line.
People who have Scheuermann's Kyphosis usually do not have nerve problems from the spinal deformity. However, a severely rounded spine can squeeze the contents of the chest and abdomen. The disorder may eventually put pressure on the heart, lungs, and abdomen. This can cause chest pain, shortness of breath, and loss of appetite.