Mid-Back (Thoracic)
Scheuermann's Kyphosis
쇼이어만병 (청소년 후만증)
Adolescent rigid thoracic kyphosis
- How common
- 0.4–8% of adolescents
- Typical age
- Ages 10–18
What is it?
Anterior vertebral endplate growth disturbance produces wedge-shaped vertebrae and rigid kyphosis.
Commonly affected: Apex typically at T7-T9
How it develops
- Endplate DisturbanceAnterior endplate growth abnormality
- Schmorl's NodesNucleus herniates through endplate
- Wedge DeformityAnterior-posterior height discrepancy
- Rigid KyphosisDoes not correct with extension
Symptoms
- Hunched postureVisible thoracic rounding
- Back painPain at apex, worse with activity
- RigidityCannot correct actively
- Muscle fatiguePeriscapular muscle fatigue
How it is examined
- Adams forward bendSharp angular kyphosis with forward bend
- Kyphosis measurementCobb angle >45° abnormal
- Normal neurologicUsually no deficit
- Compensatory lumbar lordosisCompensatory lumbar hyperlordosis
Imaging
Standing lateral full-spine X-ray — measure Cobb angle, assess wedging.
- ≥3 consecutive wedged vertebrae (>5°)
- Schmorl's nodes
- Endplate irregularity
- Disc narrowing
MRI for severe cases to assess cord.
- Wedged vertebrae
- Schmorl's nodes
- Disc degeneration
Non-surgical care
- Extension exercisesThoracic extension and core strengthening
- Milwaukee braceFor Cobb 55–75° with remaining growth
- NSAIDsPain control
- Posture educationErgonomic and postural correction
Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.
When surgery is considered
Cobb >75°, refractory pain, neurologic symptoms
Procedures that may be discussed
- Posterior instrumented fusion ± osteotomy
Outlook
Bracing effective in growing patients; adults focus on pain/deformity management.