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Scheuermann's disease: description
Scheuermann's disease refers to a relatively common youthful growth disorder of the spine, whereby this mostly occurs Chest height occurs (thoracic), more rarely in Lumbar region (lumbar). Boys are affected much more often than girls. The severity of Scheuermann's disease differs from case to case.
Structure of the spine
In order to understand what happens with Scheuermann's disease, one has to know the structure of the spine. Roughly simplified, they can be imagined as cubes (vertebral bodies) stacked on top of each other with elastic buffers (intervertebral discs) between them. The stack is by no means straight. Viewed from the side, he has one double "S" shape. Like every structure of the human body, the spine must also grow synchronously in childhood and adolescence. In Scheuermann's disease, however, this happens unevenly, so that the vertebral bodies one wrong shape accept.
How does Scheuermann's disease work?
In relation to the cube model, this means that the (ventral) front edge of the cube looking towards the chest / abdomen grows more slowly than the rear (dorsal) edge. As a result, the vertebral body takes on the shape of a wedge, the tip of which points towards the abdominal side.
Therefore, in the context of Scheuermann's disease, so-called Wedge vertebrae the speech. If several such wedge vertebrae are on top of each other, this results in a pathological curvature of the spine. There is a slight, backward curvature (Kyphosis) normal in the thoracic vertebral area, but in Scheuermann's disease it is often too severe. In such cases one speaks of a Hyperkyphosis.
If the lumbar vertebra area is affected, Scheuermann's disease causes a weakening of the natural forward curve there (Lordosis) the spine, in rare cases the severity of the disease is so severe that kyphosis develops here too. In addition to the backward curvature, those affected can also experience a sideways curvature of the spine, which one can Scoliosis is called.
Scheuermann's disease: symptoms
Scheuermann's disease can take very different forms. Sometimes it does not cause any noticeable discomfort at first and is only an incidental finding. In more severe cases, on the other hand, those affected suffer from:
- a pronounced humpback respectively Hunchback. The shoulders usually also fall forward.
- Restrictions on movement, especially when trying to turn the upper body.
- Pain, about which about a fifth of young people complain. The symptoms often only develop in the further course.
- severe psychological stress due to the aesthetic aspect.
If deformations of the spine lead to a strongly curved posture, Scheuermann's disease can also cause breathing problems. Long-term consequences In addition to pain and poor posture, the disease can also neurological symptoms such as Paresthesia be on certain parts of the body. These arise from pressure on the nerve tracts that are responsible for the sensation reports. Scheuermann's disease patients also tend to be more likely to Herniated discs in the lumbar spine area. These complications that only occur later are summarized under the term "Post-Scheuermann Syndrome".
Scheuermann's disease: causes and risk factors
It is not known exactly what ultimately triggers Scheuermann's disease. It does appear to be one hereditary component to give because the disease occurs in families. For example, a general Low resilience the vertebral bodies are present, as well congenital abnormalities on their edge strips. Also Vitamin deficiency syndromes can play a role.
There are also certain Risk factorsthat favor Scheuermann's disease:
- long, bent over sitting with an increased Bending load for the spine.
- a weak back muscles.
- sportswhich are too strong Compression and torsional loads for the spine (martial arts, ball sports, running on hard surfaces).
As a result of these factors, the vertebral bodies of the lower thoracic spine in particular are increasingly stressed on their front side. Under certain circumstances, damage to the base and cover plates occurs, so that the growth zones of the vertebrae are impaired. The result is uneven growth - the full picture of Scheuermann's disease develops.
Scheuermann's disease: examinations and diagnosis
First, the doctor needs to ask important questions Medical history in order to narrow down the symptoms and exclude diseases with a similar appearance as Scheuermann's disease. It is also important when and in which area the pain started, if any. The nature of the pain (dull, stabbing, constant or movement-dependent) is also important. At the same time, the doctor searches for functional restrictions and neurological symptoms. Questions about professional, sporting and leisure activities can provide important information on factors that promote illness.
This is followed by the physical examination in which the shape of the spine, mobility and pain intensity can already be assessed. This can also be used to determine the severity of Scheuermann's disease. The clinical picture is then confirmed with apparatus-based diagnostics (especially X-ray examinations). The so-called Cobb angle, which can be determined from the X-ray images based on the vertebral body positions, describes the extent of the curvature. This value is also for the process control very important.
In individual cases, Nuclear spin (MRI) - and Computed Tomography (CT) can be used.
Occasionally, Scheuermann's disease happens by chance during another examination, such as a lung x-ray.
Scheuermann's disease: treatment
The goal of treating Scheuermann's disease is to prevent severe deformation of the spine. The earlier the disease is discovered, the more successful it is. In the foreground is initially one conservative therapy. Surgery is rarely performed.
With the help of physiotherapy can through special exercises the Muscle groups that counteract a curvature of the spine. This also keeps the affected spine sections mobile. In addition, those muscle parts that are incorrectly stressed and shortened due to the incorrect posture are specifically stretched.
From a certain degree of curvature, wearing a Support corsets recommended, mainly to prevent Scheuermann's disease from progressing further. In the first year, the corset should be worn 23 hours a day, then only at night. It must be checked regularly and readjusted if necessary. Since affected children and adolescents are often teased because of their corset, there is usually one great resistance against this therapy. However, if used consistently good results be achieved.
You can't do anything against the causes of Scheuermann's disease with medication, but you can do against some symptoms. For example, the active ingredients are used against the pain Paracetamol and Ibuprofen a. Muscle relaxing drugs (muscle relaxants) can help against tension that is caused by persistent poor posture.
An operation for Scheuermann's disease usually only occurs when the patient's growth phase has been safely completed and a certain angle of curvature has been exceeded. However, other criteria such as chronic pain, impaired lung function or cosmetic aspects also play a role.
The operation will be damaged Discs removed and replaced by the body's own bone material, the spine is straightened and stabilized with the help of metal plates and screws. A corset often has to be worn for a few months after an operation.
Read more about the therapies
Read more about therapies that can help here:
Scheuermann's disease: disease course and prognosis
Scheuermann's disease usually begins with the first adolescent growth spurt and progresses further during growth. Once this has been completed, the deformations and damage to the vertebral bodies also persist at this level. However, they remain lifelong and cannot be reversed. The resulting poor posture and stress on the spine often results in increasing complaints over time (see: "Scheuermann's disease: symptoms and complications").
Using certain parameters such as the Cobb angle, the progression of Scheuermann's disease can be monitored during the growth phase.
Other important Prognostic factors are:
- the severity of the deformation the spinal cord,
- the extent of a possible accompanying scoliosis, as
- the body weight. If the patient is overweight, the prognosis worsens.
If therapy is started in good time, the prognosis is usually favorable. Severe forms of a Scheuermann's disease are rather the exception.
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