Scheuermann kyphosis

The etiology of Scheuermann kyphosis (SK) is unknown. There is probably a strong hereditary pattern. It is a condition that by general agreement is defined by the wedging of more than 5°in three consecutive vertebrae. Scheuermann kyphosis patients generally present to physicians for concerns over deformity and pain. Natural history studies show that the pain generally subsides, but the deformity may be static or worsen. Natural history studies for an extended period show no evidence of increased morbidity or increased mortality for patients with thoracic SK. The majority of cases never present for medical treatment. Most who present to a physician have mild deformity and minimal symptoms and do not require active treatment. In patients with progressive deformity or severe deformities, treatment is advised. Some weak evidence exits that a brace can affect the deformity if applied during growth, while the efficacy of other nonoperative measures - physical therapy and exercises - although widely prescribed have not been scientifically validated. In more severe cases of SK, significant deformity can result. The acceptability of deformity and decisions referable to the surgical treatment of the deformity varies widely in different societies. The surgical correction of kyphosis, although feasible, is associated with significant risks. Newer generation instrumentation may improve deformity correction and lessen the risk of complications. Studies are needed to identify risk factors in progression.