Treatment of Kyphosis and Scheuermann's Disease
SpineUniverse talked to Dr. Thomas Lowe, an orthopaedic surgeon and spine specialist in Colorado about these conditions.
Dr. Lowe: Structural kyphosis - the type caused by an abnormality in the structures of the spine, such as Scheuermann's disease - cannot be prevented. However, in many cases it can be corrected through bracing and, as I mentioned earlier, surgery. Postural kyphosis is something that can be corrected by using good body mechanics and a back exercise program.
Body mechanics refers to how well we keep our body in balance and avoid excessive stress on our spines. Many people get so used to bad posture (slouched shoulders, head down, knees bent); they don't even know they are doing it until they start having back pain. Here's what good posture looks like when you are standing:
Feet slightly apart
Chin slightly tucked in
Having good posture may not protect you from ever having back pain, but it plays an important role in keeping your spine (and the rest of your body) healthy.
SpU: Is the treatment for kyphosis different from Scheuermann's disease?
Dr. Lowe: The treatment plans are similar but differ depending on the patient's age, curve magnitude, and coexisting medical and neurological problems. Fortunately, neurological difficulties are rare. In the case of Scheuermann's disease, early intervention is most important. Non-surgical treatments may include annual observation, bracing (Figure 3), and physical therapy. Patients with postural kyphosis are often encouraged to participate in a physical therapy program that includes posture training and exercise to strengthen the spinal muscles.
Figure 3. An example of brace treatment.
SpU: Are these conditions treated surgically?
Dr. Lowe: Yes - there are instances when a patient with kyphosis or Scheuermann's disease requires surgery. Surgery may be indicated if the curve is severe and progressive, neurological symptoms exist, and pain cannot be adequately resolved non-operatively (e.g. physical therapy, back exercises). The surgery always includes spinal instrumentation and fusion to correct the deformity and permanently stabilize the spine.
Figure 4. (Left) Patient before surgery with pre-operative x-ray. (Right) Same patient after surgery.
SpU: Thank you Dr. Lowe for answering our questions about kyphosis and Scheuermann's Disease.