DEAR DR. GOTT: My grandson, who is 15, was just diagnosed with type II Scheuermann disease of the spine. This was discovered when he had X-rays following a minor moped accident. His doctor has prescribed a muscle relaxant and an anti-inflammatory, along with having him go to physical therapy. What can you tell me about this disease? Will he need to be on medication the rest of his life? Is there a cure for it? What is the cause, and is it hereditary?
His mother has a Harrington’s rod on her spine for scoliosis. Thank you for any information you can provide.
DEAR READER: Scheuermann’s disorder of the spine is more commonly known as adolescent kyphosis, a humplike curvature caused by the wedging together of several vertebra in a row, commonly between the T7 and T9 levels of the spine. This can occur when the front of the upper spine fails to grow at the same rate as the back of the spine. Normal thoracic curvature is between 20 and 50 degrees. Scheuermann kyphosis is diagnosed if three or more adjacent vertebrae have wedged at least 5 degrees. While rare at birth, it can occur at any age. When it occurs in adults, it can be the result of a fracture, the slipping of one vertebra forward on another, specific connective tissue disorders, endocrine disease, Paget’s disease, tumors, spina bifida and several other causes.
Diagnosis can be made through examination by a physician and X-rays of the spine. When a tumor or neurological symptoms are present, a physician may choose to order an MRI for confirmation.
Treatment depends on the specific reason for the disorder. If a tumor or infection is involved, surgery may be recommended. If pain and pronounced curvature is involved, a brace and physical therapy might be appropriate. Congenital forms might require corrective surgery at a young age. If degenerative joint disease is involved or if there are numerous compression fractures, surgery may be necessary to reduce the level of pain and correct the deformity. There is no one specific treatment recommended.
Scheuermann’s isn’t a disease, nor is it contagious. The good news is that the disorder ceases when an adolescent stops growing. My guess is that his doctor is well informed and is providing appropriate care.
To send you additional information, I am forwarding a copy of my Health Report “Managing Chronic Pain.” Other readers who would like a copy should send a self-addressed, stamped No. 10 envelope and a $2 US check or money order to Newsletter, PO Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print out an order form from my website www.AskDrGottMD.com.
About Dr. Gott