Scheuermann’s kyphosis is a rounding of the back that arises from disturbances in the normal growth and development of the spinal column during the adolescent growth spurt. This causes wedging of vertebrae (building blocks of the spinal column), and irregularities of the growth plates and discs between successive vertebrae (see Figure). The condition is often painful and is more common in males than females. It is often painful and can cause a significant deformity of the spine also known as roundback. In some individuals, roundback does not occur but the patient may have pain and stiffness of the back.
Disc wedging and irregular plates
Patients with Scheuermann’s kyphosis may have pain in several locations including the apex (most protruding part of the back) of the deformity, the upper back and neck, and/or the lower back. Some individuals will develop stress fractures in the lower back, termed spondylolysis, due to the fact that the lower back hyperextends to compensate for the upper back rounding. Many patients will also have a degree of scoliosis as well.
Treatment of Scheuermann’s kyphosis depends on how severe the kyphosis is and whether or not it is progressive (worsening) and how much pain and growth is remaining. For growing adolescents who have progressive curvature or worsening of the round back, bracing and physical therapy and home exercise is prescribed. For skeletally mature (not growing) adolescents and adults, physical therapy that emphasizes strengthening of the extensor muscles of the back and the core muscles of the trunk and anti-inflammatory medication as needed for pain are prescribed. Surgery is considered for those with severe, progressive kyphosis and or back pain that is not responding to non-surgical care. Before surgery is performed, an MRI of the entire spine is done to rule out any disc herniations that could place the spinal cord at risk during the corrective operation.
Dr. Lonner has been a leader in research into treatment and outcomes of Scheuermann’s Kyphosis. He has authored nearly a dozen papers on this topic. Through this research, he has helped to improve outcomes and decrease complications in the treatment of this condition. Patients undergoing surgery for Scheuermann’s kyphosis have been shown to have dramatic improvements in their quality of life including pain relief, improved self image, and function.
Patient Story 1
This is a 16- year-old young man with Scheuermann’s thoracic hyperkyphosis with severe back pain. His pain made it difficult to sit for long periods of time and to play golf and tennis, two sports in which he was an avid participant. He underwent physical therapy for approximately three years with failure to resolve the correction or alleviate his back pain. Dr. Lonner performed posterior spinal fusion to correct his Scheuermann’s kyphosis. He now is able to play tennis without pain and is currently playing on a college team.
Patient Story 2
This 14-year-old young man is a cross country runner with Scheuermann’s Kyphosis. He underwent posterior spinal fusion for thoracic hyperkyphosis, which was performed by Dr. Lonner. He was able to return to full activities with no pain several months following the procedure.