Atypical lumbar Scheuermann's disease: A presentation of 6 cases

Abstract

Scheuermann's disease is the most common cause of kyphosis in adolescence, and one of the most common causes of back pain in this age group. It is most commonly located in thoracic spine and is generally painless. Scheuermann's disease in the lumbar spine is less known and may go undetected in daily clinical practice. Blumenthal described this entity as atypical lumbar Scheuermann's disease. This form presents with Schmorl's hernias in one or two vertebral bodies, with narrowing of disc space and changes in the vertebral plates. It is more often painful and it can be confused with traumatic, infectious or tumour diseases. In most patients, a radiographic study is enough to establish the diagnosis and to differentiate both forms. Our series consists of six patients affected with the atypical form of lumbar Scheuermann's disease and diagnosed by us. All patients had a repeated history of back pain with associated Schmorl's hernias, and a very high increase in lateral diameter in radiographic views of the lumbar spine. Involvement of a single vertebral body was the most prevalent (50% of cases), and the 4th lumbar vertebra was the most commonly affected. All patients returned to normal activities after conservative treatment with temporary immobilization and NSAIDs during pain episodes.