Scheuermann’s disease /shoi″ərmonz/ [Holger W. Scheuermann, Danish surgeon, 1877–1960] , an abnormal skeletal condition characterized by a fixed kyphosis that develops at puberty and is caused by wedge-shaped deformities of one or several vertebrae. The cause of the disease is unknown, but authorities have speculated that it may result from infection, inflammatory processes, aseptic necrosis, disk deterioration, mechanical influences, inadequate circulation during rapid growth, or disturbances of epiphyseal growth caused by protrusion of the intervertebral disk through deficient or defective cartilaginous plates. The most striking pathological feature of Scheuermann’s disease is the presence of wedge-shaped vertebral bodies, seen on radiographic examination, that create an excessive curvature. Scheuermann’s disease occurs most frequently in children between 12 and 16 years of age, with the onset at puberty, and the incidence is greater in girls than in boys. The onset is insidious and often associated with a history of unusual physical activity or participation in sports. The most frequent symptom is poor posture, with accompanying symptoms of fatigue and pain in the involved area. Tenderness and stiffness may also affect the area involved or the entire spinal column. In most affected individuals the kyphosis is within the thoracic vertebrae. If the disease is diagnosed at the onset, the associated posture may be corrected actively and passively. Otherwise, the associated posture becomes fixed within a period of 6 to 9 months. The most effective treatment of Scheuermann’s disease is immobilization with a plaster cast or with a Milwaukee brace. The immobilization is continuous for 10 to 12 months, with additional immobilization at night for about the same length of time. Immobilization is usually supplemented with an exercise program that is continued after the immobilization is terminated. In adults persistent pain in the thoracic area may indicate a degenerative alteration secondary to this disease process, and spinal arthrodesis may be required to relieve the symptoms. Also called adolescent vertebral epiphysitis, juvenile kyphosis.
