Abstract

Introduction: Scheuermann’s disease (SD) is a one of the most common structural hyperkyphosis of the spine in adolescents. Two types of SD are distinguished, typical in the thoracic spine (SDT) and atypical in the thoracolumbar spine (SDTL). It differently affects the cervical spine alignment. The aim of this study was to evaluate the morphology of the cervical part of the vertebral column in SD patients and an analysis of the possible differences between the SDT and SDTL.

Methods: Eighty-six patients with SD (52 males and 34 females), aged: 16.3 ± 3.7 years were included into the study. On standing lateral radiographs the cervical spine alignment was classified as lordotic, straight, sigmoid or kyphotic according to the morphological classification. The following parameters were measured: measurements were made C2-7 cervical lordosis (CL), T5-T12 thoracic kyphosis (TK), L1-L5 lumbar lordosis (LL), T10-L2 thoracolumbar kyphosise (TLK), cervical sagittal vertical axis (cSVA). All the parameters were compared between SDT and SDTL groups

Results: There were 48 SDT and 38 SDTL patients. There were 32 males and 16 females in the SDT group versus 20 males and 18 females in STDL group, p=0.2714. The alignment of the cervical spine was lordotic in 56.2% SDT and 34.2% SDTL, straight in 37.5% SDT and 36.8% SDTL, kyphotic in 4.2% SDT and 15.8% SDTL and sigmoid in 2.1% SDT and 13.2% SDTL, p=0.0289. CL was greater in SDT-19.8° than in SDTL-8.5°, p=0.0089. There was no significant difference in cSVA 16.9mm in SDT vs. 12.9 in SDTL, p=0.2599.

Conclusion: The type of the Scheuermann’s disease has an impact on the cervical spine morphology. There is a higher tendency to the kyphotic and the sigmoid cervical spine alignment in the thoraco-lumbar type than in the thoracic type of Scheuermann disease.

Keywords: Scheuermann’s disease; Juvenile kyphosis; Scheuermann’s kyphosis; Cervical spine alignment; Spine alignment; Scheuermann disease; Morphological classification; Cervical spine morphology

Abbreviations: SD: Scheuermann’s Disease; SDT: Thoracic localization of the Scheuermann’s Disease; SDTL: Thoracolumbar Localization of the Scheuermann’s Disease; CL-C2-C7: Cervical Lordosis; TK-T5-T12: Thoracic Kyphosis; LL-L1-S1: Lumbar Lordosis; TLK-T10-L2: Thoracolumbar Kyphosis; cSVA: Cervical Sagittal Vertical Axis