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Órgano Oficial de difusión científica de la Asociación Mexicana de Cirujanos de Columna A. C.

2025, Number 4

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Cir Columna 2025; 3 (4)

Scheuermann's disease: case analysis and management and follow-up recommendations

Navarro ADE, Cruz LF, Dittmar JHM, Tejera MA, Díaz OO, Rodríguez LA, Muñoz LJA, Haro EJA, Sánchez GFJ

Language: Spanish
References: 36
Page: 296-304
PDF size: 478.57 Kb.


ABSTRACT

Scheuermann's disease represents a distinct form of structural kyphosis that predominantly affects adolescents during their growth period. This condition is characterized by marked kyphosis of the thoracic or thoracolumbar spine, accompanied by characteristic structural changes such as wedge-shaped vertebrae, irregularities in the vertebral endplates, and the presence of Schmorl's nodes. Unlike other postural deformities, Scheuermann's disease involves permanent morphological alterations in the affected vertebrae. This musculoskeletal disorder not only impacts the patient's posture and anatomy but can also lead to chronic pain and significant physical limitation, especially when it is not detected and treated promptly during adolescence. The natural progression of the disease may result in irreversible structural deformity, even with the best available treatment in advanced cases. Protrusion of the intervertebral discs and secondary degenerative changes frequently cause severe symptoms that pose a considerable therapeutic challenge. Characteristic radiological findings show dorsal kyphosis ranging between 50° and 70°, often accompanied by variable degrees of scoliosis and anterior wedging in at least three consecutive vertebrae. Therapeutic management should be individualized based on the severity of the deformity, the patient's age, and the presence of symptoms. Treatment options range from conservative measures such as physical therapy and bracing to surgical interventions in severe or refractory cases. It is important to note that surgical intervention is reserved for severe cases (kyphosis > 75°) with intractable pain or documented progression despite conservative treatment, neurological deficits, cardiopulmonary compromise, or poor skeletal plasticity. Long-term follow-up is essential to monitor the progression of the deformity and the development of secondary complications. The patients included in this study present a notably variable clinical spectrum, ranging from asymptomatic individuals with visible deformity to those experiencing debilitating chronic pain and significant functional limitations. This report presents treatment strategies aimed at maintaining adequate functionality and provides recommendations for follow-up, particularly during the growth period, to optimize long-term outcomes.


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