The disease is classified based on the location and severity:

1. Thoracic type: Affects the thoracic spine and leads to pronounced kyphosis.
2. Thoracolumbar type: Affects the transition between the thoracic and lumbar spine, which can cause a combination of kyphosis and lordosis.
3. Lumbar type: Refers to the lumbar spine, where increased lordosis occurs.
4. Severe course: Significant deformities of the vertebral bodies, leading to long-term movement restrictions and functional impairments.

The exact causes of Scheuermann's disease are not fully known, but various factors play a role:

• Genetic predisposition:
  • The disease often occurs more frequently in families, indicating a hereditary component.
• Growth disorders:
  • An imbalance between the growth of the vertebral bodies and the stability of the surrounding structures can promote the disease.
• Mechanical stress:
  • Repeated unilateral stresses or poor posture can additionally strain the spine.
• Weak musculature:
  • Insufficiently developed back muscles can promote the progression of the disease.

The symptoms of Scheuermann's disease vary depending on the severity and stage of the condition:

• Postural defects: Noticeable kyphosis or hyperlordosis, often in combination with a "hunchback."
• Back pain: Pain in the area of the affected spine, especially after prolonged sitting or standing.
• Movement restrictions: Limited flexibility of the spine, particularly when bending and stretching.
• Muscle weakness: Weakness of the back muscles, which worsens posture.
• Restricted respiratory function: In severe cases, breathing may be impaired by the deformed thoracic spine.

The diagnosis is made through a combination of medical history, clinical examination, and imaging techniques:

- Medical history:

- The doctor inquires about symptoms, disease progression, and family history.

- Clinical examination:

- Examination of the spine for curvatures, tenderness, and movement restrictions.

- Imaging techniques:

- X-ray: Shows typical wedge-shaped deformations of the vertebral bodies and increased kyphosis.

- MRI: Detailed representation of soft tissue structures and intervertebral discs.

- CT: Additional use in case of suspected bony changes.

Conservative Therapy

In most cases, surgery is not required, and the treatment aims to improve posture and relieve pain:

• Physiotherapy:
  • Exercises to strengthen the back muscles and improve flexibility.
• Brace Therapy:
  • In adolescents during the growth phase, a brace can correct the curvature.
• Medication Therapy:
  • Pain relievers such as NSAIDs to alleviate discomfort.
• Ergonomic Adjustments:
  • Optimization of sitting and working positions to relieve the spine.

Surgical Therapy

Surgery is considered in severe cases or persistent pain:

• Spinal Alignment:
  • Correction of the curvature by implanting screws and rods.
• Spondylodesis:
  • Fusion of certain vertebrae to restore the stability of the spine.

To prevent or slow down the progression of the disease, the following measures are recommended:

1. Regular exercise: Strengthening the back muscles through swimming, yoga, or similar sports.
2. Ergonomic posture: Avoiding poor posture through optimal sitting and working.
3. Early detection: Regular check-ups during adolescence if postural damage is suspected.
4. Strengthening the muscles: Targeted training to support the spine.
5. Movement breaks: Frequently changing positions when sitting or standing for extended periods.