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Scheuermann-Mau disease – This is a degenerative-dystrophic disease of the spinal column, manifested in its curvature. This disease is also called juvenile kyphosis. The disease manifests itself during puberty and is diagnosed with the same frequency in boys and girls. If in the early stages of the development of the disease, its symptoms turn out to be erased, then as the pathological process progresses, a pronounced stoop is formed, a hump may appear.
In 30% of cases, Scheuermann-Mau disease develops against the background of scoliosis, and thoracic kyphosis is present in this pathology in 100% of cases. You can notice the first signs of the disease even in adolescence, when the child is actively gaining growth. The disease belongs to common pathologies and is diagnosed in 1% of children aged 8 to 12 years. It should not be ignored, since it is possible to develop not only an external defect, but also the addition of neurological problems, disorders in the functioning of the heart and lungs.
Symptoms of Scheuermann’s disease
The symptoms of Scheuermann’s disease are as follows:
The manifestation of pathology falls on the pubertal period of a child’s development. But he has no complaints at this time.
The disease is detected most often by accident, when parents note that the child has begun to stoop and his posture has become incorrect.
As the disease progresses, the child develops back pain, which is most often disturbed after prolonged sitting.
Pain can be distributed throughout the back, and may occur in the interscapular region.
The spine becomes less mobile, its deformation begins to develop, which becomes more and more noticeable.
The child stoops, with a severe course of the disease, a hump quickly forms.
The pains are constantly intensifying, the back quickly gets tired, which happens even with minor loads on it. The pain becomes especially pronounced after physical exertion, after lifting weights and in the late afternoon.
If the spine is severely deformed, then this negatively affects the work of all internal organs, primarily the functioning of the heart and lungs.
Compression of the spinal cord is not excluded, which is accompanied by paresthesias, deterioration of mobility and sensitivity of the arms and legs.
Anatomical disorders in Scheuermann-Mau disease
The appearance of the patient is changing. So, normally, the human spine has 4 bends, two anteriorly (cervical and lumbar) and two backwards (thoracic and sacral). It is they that allow you to keep the body in an upright position and make it possible to transfer loads, since the spinal column works like a spring. The angles of these bends range from 20 to 40 °C, which is a physiological norm. The spine is composed of individual elements – from the vertebrae, which have a body, processes and arches. It is the body that takes on the maximum load, the arch forms the canal of the spine, and the processes of the vertebrae are connected to each other. Between the vertebrae are elastic discs.
In Scheuermann-Mau disease, the shape of the vertebrae changes from triangular to wedge-shaped. The height of the anterior sections of the vertebrae becomes smaller, while normally they should be almost equal. This affects the angle of the spine in the thoracic region. It increases from 40 °C to 45-75 °C, depending on the degree of progression of the disease. The back of the child is rounded, which leads to an uneven redistribution of the load. The intervertebral discs put pressure on the endplate and protrude into the adjacent vertebrae. As a result, Schmorl’s hernias complement the picture of Scheuermann-Mau’s disease. worsens the prognosis for recovery. The thickening of the ligaments that fix the vertebrae creates an additional obstacle to its natural growth. The more the shape of the chest is disturbed, the more the internal organs suffer.
Causes of Scheuermann-Mau disease
The exact causes of Scheuermann-Mau disease are still unknown to medical science. The vast majority of scientists are of the opinion that this pathology is classified as a genetically determined disease.
In addition, it is believed that the triggering factors for the formation of curvature of the spine are:
Injuries of the spinal column, which were received during the period of its accelerated growth;
Accelerated development of bone tissue in the posterior vertebrae;
Osteoporosis;
Violations of the formation and development of the spinal muscles;
Hormonal imbalance that occurs during adolescence;
Necrosis of the laminae of the vertebrae;
Metabolic disorders.
Stages of Scheuermann-Mau disease
For a complete understanding of this pathology, it is necessary to consider the stages of Scheuermann-Mau disease.
There are three of them in total:
hidden stage. It develops between the ages of 8 and 14. It is impossible to see the symptoms, the child does not present any complaints. If the pain in his back bothers him, then they are so weak that the teenager does not pay attention to them. Often, uncomfortable sensations appear after physical activity, which is what their patients explain. However, the spine deforms on a daily basis. These disorders can only be detected by an attentive doctor when examining a child. The specialist should pay attention to a too even back, with increased lumbar lordosis, or an increase in thoracic kyphosis. It may also be difficult for a child to comply with a request to reach out with his hands to his feet. An increase in the angle in the thoracic spine will be present even when trying to fully straighten the back.
Early stage. The transition to the next stage occurs at the age of 15 to 20 years. In the spine there are pains that bother a person more and more often. Their localization is the lumbar and lower thoracic spine. Already at this stage, intervertebral hernias often appear, with a severe development of the disease, the spinal cord is compressed.
late stage. At the last stage of the development of the disease, osteochondrosis is formed, hernias protrude, complications such as spondylarthrosis, spondylosis, and ossifying ligamentosis develop. It occurs after the age of 20 years and older. As a result of degenerative-dystrophic changes in the tissues of the spinal column, the nerve roots are compressed. This affects the sensitivity and mobility of the legs and arms.
If the disease affects the lower thoracic and upper lumbar vertebrae, then they speak of the lumbar-thoracic form of the disease, and if the middle and lower thoracic vertebrae are involved in the pathological process, then they speak of the thoracic form of the disease.
Diagnosis of Scheuermann-Mau disease
Diagnosis of Scheuermann-Mau disease begins with a survey and examination of the patient. It is important to find out whether there were diagnosed cases of the disease in close relatives.
To clarify the diagnosis, it will be necessary to perform such instrumental examination methods as:
Radiography of the spinal column. The resulting images will show thoracic kyphosis, the angle of deviation of which will be more than 45 ° C, as well as the wedge-shaped shape of the vertebrae (3 or more pieces). Depending on the stage of the disease, Schmorl’s hernias are visualized.
According to the testimony of a neurologist, MRI and CT of the spinal column are required. These studies will complement the existing picture of the disease as much as possible.
Often, when neurological disorders are detected, the patient is sent for electromyography.
In addition to the orthopedist, the patient will be treated by a neurosurgeon (if there are hernias), a pulmonologist (if a chest deformity is detected and if the lungs are malfunctioning), a cardiologist (if the cardiovascular system is disrupted).
Treatment of Scheuermann’s disease
Treatment of Scheuermann-Mau disease is a lengthy process. The approach to therapy should be comprehensive and include such methods as: physiotherapy, massage, exercise therapy. Of all these methods of influence, physiotherapy exercises play a leading role. It is thanks to the correctly selected complex that it will be possible to correct the posture and restore the normal curves of the spinal column. During the first three months, exercises are performed every day. After this time, you can perform exercises every other day. One lesson cannot last less than 40 minutes. Sometimes this time is increased to 90 minutes. If a person misses training, it will not be possible to achieve a stable positive result.
Therapeutic and physical culture complex consists of several sections:
Working out the muscles of the chest.
Working out the muscles of the buttocks.
Removal of tone and tension from the lumbar and cervical muscles.
Stretching the pectoral muscles.
Breathing exercises.
You should not give up any physical activity, but it is better if it is purposeful. After all, it is obligatory to take into account the existing contraindications, as well as other diseases and the age of the patient.
It is strictly forbidden for women with Scheuermann-Mau disease to lift loads of more than 3 kg during classes, and for men more than 5 kg. You should not engage in pumping the muscles of the sternum, as they will begin to pull the shoulders forward, which will aggravate the pathological process. Also banned are all sports that require enhanced manifestations of its depreciation capabilities from the spine. We are talking about basketball, volleyball, long jump, pole jump, etc. This is due to the fact that the risk of formation of intervertebral hernias increases. But it is very useful to swim if you do it correctly, without overstraining the pectoral muscles, but with the participation of the back muscles. To understand the technique of such swimming, you should consult with a professional.
You should also not ignore such a method of treatment as massage. But it must be performed by a professional massage therapist with a medical education. The procedure allows you to increase blood flow to the muscles, normalize their nutrition, activate metabolic processes in them, and make the muscles more plastic. Every year, people with Scheuermann-Mau disease need to undergo two massage courses of 10 treatments each.
Mud therapy allows you to achieve the same effect as from massage. So, to improve the spinal column and back muscles, you need to undergo 2 courses of treatment per year, each course should consist of at least 15 procedures.
Do not lose sight of such an important point as the competent selection of furniture for work and for a night’s rest. The bed should be flat, covered with an orthopedic mattress. Sometimes, on the recommendation of a doctor, you can use an orthopedic corset.
Medical treatment is usually not needed. It is possible that drugs to strengthen the skeleton will be prescribed – these are Miacalcic and Alostin. But they are prescribed only with a very strong deformation of the spine, as well as in the presence of large Schmorl hernias. The fact is that these drugs have a lot of contraindications, including age restrictions. They can cause calcification of the ligaments, provoke the appearance of kidney stones. Therefore, their independent reception is unacceptable.
It is possible that this disease may require surgical intervention.
Indications for its implementation are:
Kyphotic kink at more than 75°C;
Severe pain that is not stopped by conservative methods of treatment;
Disturbances in the functioning of the lungs and heart.
During the operation, the patient is inserted metal implants, which make it possible to align the spine.