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Scheuermann's disease

A traumatic spondylodystrophy?

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Abstract

The theories relating to Scheuermann's disease are reviewed. An attempt is made to resolve discrepancies in these theories in the light of radiologically derived evidence. This evidence suggests that central nodes, marginal nodes, and the irregular ossification of Scheuermann's disease, result from different mechanisms, and that the problem has been obscured by failure to consider them as separate phenomena. It is also concluded that many radiological nodes are not identical with the node as defined histologically, and that the former relate to dynamic stress while Scheuermann's disease relates to static load. It is suggested that Schmorl's theory which has irreconcilable discrepancies in the pure form, becomes acceptable when modified in the light of this evidence.

The hypothesis is advanced that Scheuermann's disease is simply a stress spondylodystrophy, sequential upon traumatic growth arrest and end-plate fractures occurring during the heightened vulnerability phase which occurs during the adolescent growth spurt. The wedging, kyphosis and irregular ossification best fit the evidence as a subsequent static load effect, resulting mainly from the chair sitting posture. It is suggested that the irregular end plates are caused by disturbed cell vectoring and traumatic growth arrest as well as microfractures, and that the first of these is probably the most important.

No evidence is found of any underlying defect, in the cartilage plate or elsewhere, which would justify the concept of constitutional abnormality.

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Authors and Affiliations

  1. Dept. of Radiology, Auckland Hospital, Park Road, Auckland 1, New Zealand

    C. J. Alexander M.D. (Professor of Radiology)

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  1. C. J. Alexander M.D.
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Alexander, C.J. Scheuermann's disease. Skeletal Radiol. 1, 209–221 (1977). https://doi.org/10.1007/BF00365787

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