This is a flexible deformity which is
not associated with any underlying bony abnormality. Poor posture and
tight muscles in the legs and chest may contribute to the problem.
In this case advice, exercise and
being made aware of a more correct posture when standing or sitting is usually
all that is required.
Exercise may also help to relieve
pain felt in the back associated with a poor posture, fitness and tone in the
muscles around the spine.
This is not a disease like measles or
mumps but a condition which is usually diagnosed following a lateral x-ray of
the thoracic spine.
The condition is associated abnormal
development of the vertebrae that results in the vertebrae becoming wedge
shaped (shorter or lower at the front than at the back).
In mild cases all that is
required is observation and advice regarding correct posture and exercise.
In more severe cases, where
there is still an expectation of considerable skeletal growth a brace may be
recommended, and in this condition there is a good chance that the brace will
halt progression, and in fact result in an improved posture once skeletal
maturity is achieved.
If a brace is to be used it must
be worn for 23 hours per day until growth has almost finished, and will then
usually continue to be used only at night for a further six months.
In cases where growth has
already neared completion or where deformity is severe surgical intervention
may be considered or recommended. The exact degree of kyphosis that
required correction is not clear-cut but in general the curve should be
greater than 60o, progressive (getting worse) or where there is already a
significant clinical deformity. Surgery may also be considered where
there is persistent and significant pain and should be undertaken if there is
evidence of spinal cord compromise or respiratory problems caused by the
deformity.
Below are the radiographs of a
14 year old boy with Scheuermann's kyphosis who had what he considered to be
an unacceptable clinical appearance and thoracic back pain. He underwent
surgery to correct his posture and address his pain. This is however
quiet major surgery and is not indicated in the majority of cases.
