Scheuermann's Disease: New Impressions of Clinical and Radiological Evaluation and Treatment Approaches; A Narrative Review

Context: Scheuermann’s disease (kyphosis) is an essential kyphosis of the thoracic spinal column, and it is the most public source of kyphosis in adolescents. It has been shown that the imaging characteristics of the disease are sequential 3 vertebrae by minimum 5 degrees of wedging of anterior part of vertebral body. Frequently, the disease is presented at 8 to 12 years of age. Kyphosis is regularly managed with conservative methods. The purpose of this review was to discuss challenging issues in evaluation and treatment of this disease in the mentioned age group.
Evidence Acquisition: Medline, Google scholar, PubMed and Ovid were searched and a total of 44 articles were found to be involved in the pediatric evaluation of this disease.
The precise basis of Scheuermann’s kyphosis remnants is unidentified. Diagnosis is made by careful clinical examination and radiologic evaluations. In neurologic defects, MRI must be taken. Conservative managing plans for SK involve observation, physical therapy, and bracing. Some writers recommended evading the operation till skeletal maturity is completed. Surgery is commonly suggested for patients with deformity progress, permanent pain, neurological discrepancy, pulmonary insufficiency, or cosmetic complain. Thoracic kyphosis with curving of smaller than 75 degrees seldom requires surgery. Posterior only or combined with anterior methods are the surgery options based on severity of disease.
Today, new and more modern braces have been designed to increase global advantages of bracing in Scheuermann’s disease. Patients with more than 75 degrees of curving, kyphotic progress, intolerable cosmetic features, or neurological discrepancy might be supposed for operation. New surgical procedures permit improved correction of the deformity via posterior surgery with lesser complication rates. Concurrent shortening of the posterior spinal column crossways the apical levels, combined by monitoring of spinal cord, decreases the danger of neurological deficits. Though patients state great satisfaction rates through surgery, both proximal and distal junctional complications can remain. New systems with dynamic instrumentation and improving surgical methods with biologic handling are almost convinced to become typical treatment possibilities.