European Spine Journal

, Volume 21, Issue 5, pp 819–824 | Cite as

Untreated Scheuermann’s disease: a 37-year follow-up study

  • L. RistolainenEmail author
  • J. A. Kettunen
  • M. Heliövaara
  • U. M. Kujala
  • A. Heinonen
  • D. Schlenzka
Original Article



There are only a few follow-up studies of untreated Scheuermann’s disease. The aim of this study was to investigate the relationship between vertebral changes, back pain, and disability in patients with untreated Scheuermann’s disease after a 37-year follow-up.

Materials and methods

Eighty patients responded to a postal questionnaire concerning back pain and disability and 49 of them had classic Scheuermann’s disease. Degree of kyphosis, lordosis, scoliosis, the number of affected vertebrae, and mean and maximum wedge angles were measured from radiographs. Back pain and disability scores were compared to a sample of the general Finnish population (n = 3,835).


At follow-up, the patients were on average 59 (SD 8) years old (range 44–79 years), and the mean follow-up time was 37 (SD 7) years (26–54 years). The patients comprised more males than females (3.1:1). At follow-up, male patients were on average 3 cm taller than controls (p = 0.007). At age 20, female patients compared to controls were on average 6 kg heavier (p = 0.016) and had higher body mass index (BMI) (mean 23.9 kg/m2 vs. 20.8 kg/m2, p = 0.001). Scheuermann’s patients had 2.5-fold [odds ratio (OR); 95% confidence interval (CI); 1.4–4.5, p = 0.003] increased risk for constant back pain compared to controls. The risk for disability because of back pain during the past 5 years (OR 2.6; 95% CI 1.4–4.7, p = 0.002), risk for back pain during the past 30 days (OR 3.7; 95% CI 1.9–7.0, p < 0.001) and risk for sciatic pain (OR 2.3; 95% CI 1.3–4.3, p = 0.005) were higher compared to controls. Scheuermann’s patients had higher risk for difficulties in mounting stairs (OR 5.4; 95% CI 2.8–10.3, p < 0.001) and in carrying a 5 kg load for at least 100 m (OR 7.2; 95% CI 3.9–13.3, p < 0.001).


Scheuermann’s patients had a higher risk for back pain and disabilities during activities of daily living than controls. However, the degree of thoracic kyphosis among Scheuermann’s patients was not related to back pain, quality of life, or general health.


Scheuermann’s Thoracic hyperkyphosis Juvenile osteochondrosis Natural history 


Conflict of interest



  1. 1.
    Ascani E, Salsano V, Giglio G (1977) The incidence and early detection of spinal deformities. A study based on the screening of 16,104 schoolchildren. Ital J Orthop Traumatol 3(1):111–117PubMedGoogle Scholar
  2. 2.
    Aufdermaur M (1981) Juvenile kyphosis (Scheuermann’s disease): radiography, histology, and pathogenesis. Clin Orthop Relat Res 154:166–174PubMedGoogle Scholar
  3. 3.
    Bradford DS (1977) Juvenile kyphosis. Clin Orthop Relat Res 128:45–55PubMedGoogle Scholar
  4. 4.
    Bradford DS, Moe JH, Montalvo FJ, Winter RB (1974) Scheuermann’s kyphosis and roundback deformity. Results of Milwaukee brace treatment. J Bone Joint Surg Am 56(4):740–758PubMedGoogle Scholar
  5. 5.
    Cobb J (1948) Outline for the study of scoliosis. Instr Course Lect 5:261–275Google Scholar
  6. 6.
    Damborg F, Engell V, Andersen M, Kyvik KO, Thomsen K (2006) Prevalence, concordance, and heritability of Scheuermann kyphosis based on a study of twins. J Bone Joint Surg Am 88(10):2133–2136PubMedCrossRefGoogle Scholar
  7. 7.
    Edgren W, Vainio S (1957) Osteochondrosis juvenilis lumbalis. Acta Chir Scand Suppl 227:1–47PubMedGoogle Scholar
  8. 8.
    Fisk JW, Baigent ML, Hill PD (1982) Incidence of Scheuermann’s disease. Preliminary report. Am J Phys Med 61(1):32–35PubMedGoogle Scholar
  9. 9.
    Fotiadis E, Kenanidis E, Samoladas E, Christodoulou A, Akritopoulos P, Akritopoulou K (2008) Scheuermann’s disease: focus on weight and height role. Eur Spine J 17(5):673–678PubMedCrossRefGoogle Scholar
  10. 10.
    Graat HC, van Rhijn LW, Schrander-Stumpel CT, van Ooij A (2002) Classical Scheuermann disease in male monozygotic twins: further support for the genetic etiology hypothesis. Spine (Phila Pa 1976) 27(22):E485–E487CrossRefGoogle Scholar
  11. 11.
    Kalifa G, Cohen PA, Hamidou A (2002) The intervertebral disk: a landmark for spinal diseases in children. Eur Radiol 12(3):660–665PubMedGoogle Scholar
  12. 12.
    Lonner BS, Kean KE, Sponseller P, Shufflebarger HL, Shah S, Crawford A, Betz RR, Newton PO (2009) Body mass index in Scheuermann’s kyphosis (SK): does BMI differ in patients with sk versus adolescent idiopathic scoliosis (AIS)? In: Podium 44th Annual Scoliosis Research Society Meeting, San Antonio, TX, September 23–26, 2009Google Scholar
  13. 13.
    Lowe TG (1990) Scheuermann disease. J Bone Joint Surg Am 72(6):940–945PubMedGoogle Scholar
  14. 14.
    Lowe TG (1999) Scheuermann’s disease. Orthop Clin North Am 30(3):475–487PubMedCrossRefGoogle Scholar
  15. 15.
    Murray PM, Weinstein SL, Spratt KF (1993) The natural history and long-term follow-up of Scheuermann kyphosis. J Bone Joint Surg Am 75(2):236–248PubMedGoogle Scholar
  16. 16.
    Nissinen M (1995) Spinal posture during pubertal growth. Acta Paediatr 84(3):308–312PubMedCrossRefGoogle Scholar
  17. 17.
    Poussa MS, Heliovaara MM, Seitsamo JT, Kononen MH, Hurmerinta KA, Nissinen MJ (2005) Development of spinal posture in a cohort of children from the age of 11 to 22 years. Eur Spine J 14(8):738–742PubMedCrossRefGoogle Scholar
  18. 18.
    Rachbauer F, Sterzinger W, Eibl G (2001) Radiographic abnormalities in the thoracolumbar spine of young elite skiers. Am J Sports Med 29(4):446–449PubMedGoogle Scholar
  19. 19.
    Scheuermann H (1920) Kyfosis dorsalis juvenilis. Ugeskr Laeger 82(12):385–393Google Scholar
  20. 20.
    Scoles PV, Latimer BM, DigIovanni BF, Vargo E, Bauza S, Jellema LM (1991) Vertebral alterations in Scheuermann’s kyphosis. Spine (Phila Pa 1976) 16(5):509–515CrossRefGoogle Scholar
  21. 21.
    Sorensen K (1964) Scheuermann’s juvenile kyphosis: clinical appearances, radiography, aetiology, and prognosis. Munksgaard, CopenhagenGoogle Scholar
  22. 22.
    Wenger DR, Frick SL (1999) Scheuermann kyphosis. Spine (Phila Pa 1976) 24(24):2630–2639CrossRefGoogle Scholar
  23. 23.
    Zaina F, Atanasio S, Ferraro C, Fusco C, Negrini A, Romano M, Negrini S (2009) Review of rehabilitation and orthopedic conservative approach to sagittal plane diseases during growth: hyperkyphosis, junctional kyphosis, and Scheuermann disease. Eur J Phys Rehabil Med 45(4):595–603PubMedGoogle Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • L. Ristolainen
    • 1
    • 5
    Email author
  • J. A. Kettunen
    • 2
  • M. Heliövaara
    • 3
  • U. M. Kujala
    • 4
  • A. Heinonen
    • 4
  • D. Schlenzka
    • 1
  1. 1.ORTON Orthopaedic Hospital and ORTON Research InstituteHelsinkiFinland
  2. 2.Arcada, The University of Applied SciencesHelsinkiFinland
  3. 3.National Institute for Health and WelfareHelsinkiFinland
  4. 4.Department of Health SciencesUniversity of JyväskyläJyväskyläFinland
  5. 5.ORTON Orthopaedic HospitalHelsinkiFinland

Personalised recommendations