Juvenile kyphosis (Scheuermann's disease)

Abstract

Scheuermann's disease is a thoracic or thoracolumbar hyperkyphosis due to wedged vertebrae developing during adolescence. Ancient presentations of hyperkyphosis usually depict extreme gibbus formations as seen due to infection (tuberculosis) or congenital vertebral anomalies. Michelangelo's ceiling fresco in the Sistine Chapel at the Vatican shows an ignudo with a kyphosis resembling a thoracolumbar juvenile kyphosis (Fig. 1). It was painted in 1511 and is possibly the earliest pictorial representation of the disease [30]. Following Schanz, Haglund named the deformity Lehrlingskyphose (apprentice's kyphosis) as it was detected mainly in youngsters involved in heavy labor [27, 61]. He saw the cause as muscular insufficiency and mechanical overloading during growth. Credit is due to Holger Werfel Scheuermann from Denmark for first describing it in 1920 as being different from mobile postural kyphosis [62, 63, 64]. He recognized from radiographs that the wedge vertebrae formation in the thoracic spine was the underlying reason for the deformity. Scheuermann was the first to describe its typical radiographic features and named it osteochondritis deformans juvenilis dorsi. The true incidence of juvenile kyphosis is not known. It ranges from 1% to 8%, being more common in boys than in girls (ratio 2/1 to 7/1). © 2008 Springer-Verlag Berlin Heidelberg.