Treatment options for Scheuermann's disease in a teenager

Patient

Q: My 16 year old son has been diagnosed with Shermans disease and he has an obvious curvature to his spine. We have tried to get him to improve his posture however we realize that is difficult given his condition. Will a back brace help reverse some of the curvature in his spine or is it too late for that; we believe he is still growing and has not yet reached his maximum height?

Doctor

A:   Scheuermann’s disease is a deformity in the thoracic or thoraco-lumbar spine in children that is self-limited after the growth is completed. Besides the pronounced curvature of the spine (kyphosis), back pain and changes in the vertebral bodies are associated. The treatment is still controversial, meaning there is no absolute guidelines, but usually for mild cases, in order to prevent future spine problems is recommended the reduction of weight-bearing stress and avoiding intense or straining activities, combined with an exercise routine to strengthen and stretch spine muscles. The severe cases might require casting or wearing a spinal brace until skeletal maturity is reached (more or less 16 years old) to try to get improvement or stop the progression of the spine deformity. Very few cases may require surgery, possibly when the back pain is severe and intractable and the curvature is more than 75 degrees, or when the cosmetic appearance is unacceptable.

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