Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic Hospital NHS Foundation Trust, Oswestry, Shropshire, United Kingdom.
Semin Musculoskelet Radiol. 2023 Oct;27(5):522-528. doi: 10.1055/s-0043-1771334. Epub 2023 Oct 10.
Scheuermann's disease is a rigid progressive kyphosis occurring in late childhood to adolescence. It is the most common cause of sagittal imbalance and angular progressive kyphosis in adolescents associated with back pain. The exact etiology of the disease is unclear, but it is characterized by defective growth of the end plate that may result from excessive mechanical stress on a weakened end plate during spinal growth. Several other theories have been proposed, and it is thought to be a multifactorial disease occurring as a result of the interplay of multiple factors. The radiographic features consist of anterior vertebral body wedging, irregular end plates, Schmorl's nodes, and intervertebral disk degeneration. The natural history and evolution of this disease is also unknown. Conservative management with physiotherapy, rehabilitation, and bracing is the first line of treatment. Mechanical bracing helps prevent further progression of the kyphotic deformity. Surgery is mostly indicated in patients with failure of conservative management, with neurologic compromise, and for cosmetic reasons.
Scheuermann 病是一种发生在儿童晚期至青春期的刚性进行性后凸畸形。它是青少年中与背痛相关的矢状面失衡和进行性角状后凸的最常见原因。该病的确切病因尚不清楚，但特征是终板生长缺陷，这可能是由于脊柱生长过程中较弱的终板受到过度机械应力所致。已经提出了其他几种理论，并且认为它是一种多因素疾病，是多种因素相互作用的结果。放射学特征包括前椎体楔形、不规则终板、Schmorl 结节和椎间盘退变。该病的自然病史和演变也不清楚。物理治疗、康复和支具的保守治疗是一线治疗方法。机械支具有助于防止后凸畸形进一步进展。手术主要适用于保守治疗失败、有神经功能障碍和出于美容原因的患者。
