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Adolescent Kyphosis, what is it?
Adolescent Kyphosis is the abnormal arching in a teenager which over the years increases regardless of how active he is.
An increase in thoracic kyphosis over 40° implies an increase in lumbar lordosis and an eradication of the lordosis of the neck. This happens purely for mechanical reasons of support and balance.
The Scheuermann disease, otherwise known as Osteochondritis of the Spine, is met in the largest percentage of juvenile kyphosis cases visiting a Spine Center;
it is a condition that seems to have genetic causes, but it is still not known how it intervenes with the epiphyseal plates, slowing down their development, especially on their frontal part.
There are few the nonstructural Kyphosis that are due to a weak muscle extensor mechanism in a child. A special digital x-ray, however, is needed, along with special vertebra measurement tools, since many times the damage is of small extent or the patient is in childhood.
Its classical version is the image of three consecutive vertebrae displaying anomalies on the frontal surfaces of the epiphyseal plates, thus delaying normal development of the vertebrae bodies.
The damage may be of the same degree, but it may also be different. In atypical forms, we can have between 1 and 8 vertebrae affected.
The height is usually around the middle of the thorax spine, followed by the lower thorax spine, and in some cases the lumbar vertebrae are included, creating a straightening of the lumbar lordosis.
The increased pressure by the weight of the body on the already problematic epiphyses of the pathological vertebrae aggravates the problem. If pressure is continued on the epiphyses, this will reduce the height of their final configuration and will give them a wedged deformation.
Increasing the thoracic kyphosis by more than 40 ° implies an increase in lumbar lordosis as well as elimination of neck lordosis. This is for purely mechanical reasons of support and balance.
Adolescent kyphosis – Scheuermann’s disease
The Scheuermann disease, otherwise known as Osteochondritis of the Spine, is met in the largest percentage of juvenile kyphosis cases visiting a Spine Center;
Manifests itself with significantly worse deformity than functional kyphosis.
It is the most common cause of kyphosis in adolescence with a frequency of 0.4% to 10%.
It occurs most often between the ages of 12 and 15 and has no preference for gender.
Most patients are asymptomatic and are more concerned about their aesthetic appearance, but pain can be observed, especially in highly demanding athletes.
Patients suffering from Scheuermann kyphosis cannot consciously correct their posture. The top of their curve, located on the thoracic vertebrae, is quite rigid.
Scheuermann’s disease causes back and neck pain, which can be quite severe.
The patient may feel pain in the top of the curve, which is aggravated by physical activity and periods of long hours standing or sitting position.
He may also feel uncomfortable or isolated among his classmates, depending on the level of deformity.
In addition to the possible pain associated with Scheuermann disease, patients with the disease have a loss of vertebral body height with their wedge-shaped deformity and consequently have an obvious hump.
The curves in the lower thoracic region causing more pain, while higher curves show greater visual distortion.
Many with Scheuermann disease often have excessive lordosis of the lumbar spine. This is the body’s natural way of compensating for the kyphosis curve.
Often patients are tight hamstring muscles which increase lordosis and related offset the excessive kyphosis of the spine.
In addition to lordosis, 20-30% of patients with Scheuermann disease also have scoliosis, although most cases are negligible. In more severe cases, however, the kyphosis-scoliosis combination is classified as a separate condition known as kyphoscoliosis.
How do we understand adolescent kyphosis?
The clinical image of Kyphosis is characteristic, with an intense curving in the upright– lateral position, with curved shoulders, an outstretched head with a straightened neck and intense lordosis.
When the body bends forward, an intense acuminate hump is formed, this is not corrected if we place our hand on it and instruct the child to raise his back.
Diagnosis of Scheuermann disease
Scheuermann’s diagnosis is primarily radiological. In the anterior-posterior radiograph we check the following:
1- The existence of 1 – 8 vertebrae in which the anterior part is shorter than the posterior.
2- Cobb kyphosis angle greater than 50 ° to 55 °
The combination of these two elements confirms the existence of Scheuermann kyphosis and the need for treatment with overextension braces. The goal is not to load the front parts so that they develop properly.
Can be cured?
Almost 100% if detected in the early stage of rapid growth.
Treatment for Scheuermann disease depends on the patient’s condition. Several factors that determine the best treatment include:
- Severity of the angle
- Elasticity of the spine
- If the person is expected to continue growing
The patient must have more than one year of development, during which he should undergo intensive treatment.
The treatment for Scheuermann type kyphosis is mainly based on the SPONDYLOS Kyphosis brace, and secondarily on exercises.
The target of the treatment of a Scheuermann type Kyphosis with a brace, is to decompress the frontal parts of the vertebra bodies and in this way allow the epiphyses to generate adequate bone so as to eradicate the wedged deformation.
Braces are usually bulky and uncomfortable and are often rejected by teenagers. Today the situation has improved significantly and braces such as the kyphosis brace SPONDYLOS, have become less annoying and lighter.
Braces can be worn comfortably under clothing and to allow the teenager to participate in activities, including many sports.
To be most effective treatment, the brace should be worn almost 24 hours, at least initially
Braces are effective up to 75 ° angles. Of course, the earlier the treatment is started, the better the results will be.
