Scheuermann’s Disease: A Narrative Review of Treatment Standards
DOI:
https://doi.org/10.12775/QS.2026.54.70483Keywords
Scheuermann's disease, Scheuermann's kyphosis, juvenile kyphosis, brace, hyperkyphosis, surgeryAbstract
Background. Scheuermann's disease is a structural spinal deformity characterised by thoracic or thoracolumbar hyperkyphosis, defined by anterior wedging of ≥5° across three or more contiguous vertebrae, Schmorl's nodes, and endplate irregularities. Incidence ranges from 0.4% to 10% in adolescents. The atypical form shows higher prevalence among young athletes.
Aim. The purpose of this article is to evaluate and summarise the current state of knowledge regarding Scheuermann's disease.
Material and methods. A narrative literature review was conducted using Google Scholar, PubMed, Springer Link, and Scopus, with keywords related to Scheuermann's disease. English-language articles from September 2015 to January 2026 were included, with exceptions for historical sources.
Results. The natural course is mostly benign. Conservative treatment, comprising of physiotherapy, bracing, and analgesia, aims to halt progression, reduce pain, and improve posture, with bracing achieving approximately 50% correction and major pain improvement. Surgical treatment, standardised as a posterior approach, offers adequate correction with fewer complications than anterior-posterior approach. The key complication is junctional kyphosis. Sports participation is permitted post-treatment, as tolerated.
Conclusions. Scheuermann's disease is an important cause of juvenile thoracic hyperkyphosis, with persisting gaps in etiology, diagnostics, and management. Most patients lead normal lives. Conservative treatment is sufficient in most cases, with surgery reserved for patients that didn’t respond to initial measures. Deformity progression is reported in long-term observations, regardless of treatment.
References
1. Patel DR, Kinsella E. Evaluation and management of lower back pain in young athletes. Translational Pediatrics. 2017;6(3):225-235. doi:https://doi.org/10.21037/tp.2017.06.01
2. O’Donnell JM, Wu W, Youn A, Mann A, Swarup I. Scheuermann Kyphosis: Current Concepts and Management. Current Reviews in Musculoskeletal Medicine. 2023/11/01 2023;16(11):521-530. doi:https://doi.org/10.1007/s12178-023-09861-z
3. Marie-Hardy L, Slimani L, Messa G, et al. Loss of CSF-contacting neuron sensory function is associated with a hyper-kyphosis of the spine reminiscent of Scheuermann’s disease. Scientific Reports. 2023/04/04 2023;13(1):5529. doi:https://doi.org/10.1038/s41598-023-32536-1
4. Scheuermann H. Kyphosis dorsalis juvenilis. Ugeskr laeger. 1920;82:385.
5. Mansfield JT, Bennett M. Scheuermann Disease. StatPearls. StatPearls Publishing
Copyright © 2026, StatPearls Publishing LLC.; 2026.
6. Mousavi SR, Farrokhi MR, Liaghat A, Hassani A, Kazeminezhad A, Ghaffarpasand F. Atypical Scheuermann's disease with severe kyphosis and negative sagittal balance in the thoracolumbar region: A case report and literature review. International Journal of Surgery Case Reports. 2023/08/01/ 2023;109:108618. doi:https://doi.org/10.1016/j.ijscr.2023.108618
7. Sebaaly A, Farjallah S, Kharrat K, Kreichati G, Daher M. Scheuermann's kyphosis: update on pathophysiology and surgical treatment. EFORT Open Reviews. 01 Nov. 2022 2022;7(11):782-791. doi:https://doi.org/10.1530/eor-22-0063
8. Sardar ZM, Ames RJ, Lenke L. Scheuermann's Kyphosis: Diagnosis, Management, and Selecting Fusion Levels. JAAOS - Journal of the American Academy of Orthopaedic Surgeons. 2019;27(10):e462-e472. doi:https://doi.org/10.5435/jaaos-d-17-00748
9. Gennari JM, Themar-Noel C, Panuel M, et al. Adolescent spinal pain: The pediatric orthopedist's point of view. Orthopaedics & Traumatology: Surgery & Research. 2015/10/01/ 2015;101(6, Supplement):S247-S250. doi:https://doi.org/10.1016/j.otsr.2015.06.012
10. Urrutia J, Narvaez F, Besa P, Meissner-Haecker A, Rios C, Piza C. Scheuermann's disease in patients 15–40 years old: A study to determine its prevalence and its relationship with age and sex using chest radiographs as screening tool. Journal of Orthopaedic Science. 2019/09/01/ 2019;24(5):776-779. doi:https://doi.org/10.1016/j.jos.2018.12.024
11. Putukian M, Leclere LE, Herring SA, et al. The Adolescent Athlete and the Team Physician: A Consensus Statement. 2025 Update. Med Sci Sports Exerc. Feb 1 2026;58(2):371-402. doi:https://doi.org/10.1249/mss.0000000000003863
12. Cetik RM, Latalski M, Yazici M. Management of low back pain accompanying sagittal plane pathologies in children: Spondylolysis/spondylolisthesis and Scheuermann’s disease. Journal of Children's Orthopaedics. 2023;17(6):535-547. doi:https://doi.org/10.1177/18632521231215873
13. Ristolainen L, Kettunen JA, Kujala UM, Heinonen A, Schlenzka D. Progression of untreated mild thoracic Scheuermann's kyphosis – Radiographic and functional assessment after mean follow-up of 46 years. Journal of Orthopaedic Science. 2017/07/01/ 2017;22(4):652-657. doi:https://doi.org/10.1016/j.jos.2017.03.009
14. Jönsson A, Damm H, Hofvander M, et al. In old men Scheuermann's disease is not associated with neck or back pain: a Swedish cohort study. Acta Orthop. May 10 2023;94:236-242. doi:https://doi.org/10.2340/17453674.2023.12358
15. Kaspiris A, Spyrou I, Marougklianis V, et al. Insights into the Pathophysiology of Scheuermann’s Kyphosis: From Structural Deformities to Genetic Predisposition and Underlying Signalling Pathways. Biomolecules. 2026;16(1):56. doi:https://doi.org/10.3390/biom16010056
16. Schmorl G. The human spine in health and disease. The human spine in health and disease. 1971:xi, 504-xi, 504.
17. Lorente A, Barrios C, Lorente R, Tamariz R, Burgos J. Severe hyperkyphosis reduces the aerobic capacity and maximal exercise tolerance in patients with Scheuermann disease. The Spine Journal. 2019;19(2):330-338. doi:https://doi.org/10.1016/j.spinee.2018.07.002
18. Garrido E, Roberts SB, Duckworth A, Fournier J. Long-term follow-up of untreated Scheuermann’s kyphosis. Spine Deformity. 2021/11/01 2021;9(6):1633-1639. doi:https://doi.org/10.1007/s43390-021-00354-y
19. Peleg S, Kallevag RP, Dar G, Steinberg N, Lenzner Z, May H. The effect of Scheuermann's kyphosis on rib cage morphology: A skeletal study. Ann Anat. Jan 2025;257:152348. doi:https://doi.org/10.1016/j.aanat.2024.152348
20. Bezalel T, Carmeli E, Kalichman L. Scheuermann’s Disease: Radiographic Pathomorphology and Association with Clinical Features. Asian Spine J. 2 2019;13(1):86-95. doi:https://doi.org/10.31616/asj.2018.0025
21. Haselhuhn JJ, Odland K, Soriano PBO, Jones KE, Polly DWJ. A Novel Surgical Indication for Scheuermann’s Kyphosis. JAAOS Global Research & Reviews. 2024;8(3):e23.00187. doi:https://doi.org/10.5435/JAAOSGlobal-D-23-00187
22. Ristolainen L, Kettunen JA, Danielson H, Heliövaara M, Schlenzka D. Magnetic resonance imaging findings of the lumbar spine, back symptoms and physical function among male adult patients with Scheuermann's disease. Journal of Orthopaedics. 2020/09/01/ 2020;21:69-74. doi:https://doi.org/10.1016/j.jor.2020.02.004
23. Haddadi K, Kadam A, Tannoury C, Tannoury T. Scheuermann’s Disease: New Impressions of Clinical and Radiological Evaluation and Treatment Approaches; A Narrative Review. Journal of Pediatrics Review. 04/28 2018;In Pressdoi:https://doi.org/10.5812/jpr.12102
24. Yun C, Shen CL. Anterior release for Scheuermann's disease: a systematic literature review and meta-analysis. Eur Spine J. Mar 2017;26(3):921-927. doi:https://doi.org/10.1007/s00586-016-4632-z
25. MABJ DP, P F. Conservative Treatment of a Typical (Type 1) Scheuermann's Kyphosis: A Case Report. Medical Research Archives. 2025-03-29 2025;13(3)doi:https://doi.org/10.18103/mra.v13i3.6396
26. Jin C, Wang S, Yang G, Li E, Liang Z. A review of the methods on cobb angle measurements for spinal curvature. Sensors. 2022;22(9):3258. doi:https://doi.org/10.3390/s22093258
27. Lonner BS, Toombs CS, Mechlin M, et al. MRI Screening in Operative Scheuermann Kyphosis: Is it Necessary? Spine Deformity. 2017/03/01/ 2017;5(2):124-133. doi:https://doi.org/10.1016/j.jspd.2016.10.008
28. Mohokum M, Schülein S, Skwara³ A. The validity of rasterstereography: a systematic review. Orthopedic Review. 09/28 2015;7:68. doi:https://doi.org/10.4081/or.2015.5899
29. Coneys U, Tabard-Fougère A, Gavira N, Dayer R. Validating rasterstereography to evaluate thoracic kyphosis in patients with Scheuermann’s disease. European Spine Journal. 2025/03/01 2025;34(3):831-836. doi:https://doi.org/10.1007/s00586-024-08610-1
30. Etemadifar MR, Jamalaldini MH, Layeghi R. Successful brace treatment of Scheuermann's kyphosis with different angles. J Craniovertebr Junction Spine. Apr-Jun 2017;8(2):136-143. doi:https://doi.org/10.4103/jcvjs.JCVJS_38_16
31. Karimi MT, Rabczuk T. Evaluation of the efficiency of Boston brace on scoliotic curve control: A review of literature. J Spinal Cord Med. Nov 2020;43(6):824-831. doi:https://doi.org/10.1080/10790268.2019.1578104
32. Piazzolla A, Bizzoca D, Solarino G, et al. Maria Adelaide brace in the management of Scheuermann’s Kyphosis. Spine Deformity. 2021/03/01 2021;9(2):549-557. doi:https://doi.org/10.1007/s43390-020-00225-y
33. Huq S, Ehresman J, Cottrill E, et al. Treatment approaches for Scheuermann kyphosis: a systematic review of historic and current management. Journal of Neurosurgery: Spine SPI. 01 Feb. 2020 2020;32(2):235-247. doi:https://doi.org/10.3171/2019.8.SPINE19500
34. Ponte A, Orlando G, Siccardi GL. The True Ponte Osteotomy: By the One Who Developed It. Spine Deformity. 2018/01/01/ 2018;6(1):2-11. doi:https://doi.org/10.1016/j.jspd.2017.06.006
35. Kaspiris A, Spyrou I, Panagopoulos F, et al. Surgical Strategies and Challenges in Scheuermann’s Kyphosis: A Comprehensive Review. Journal of Clinical Medicine. 2025;14(12):4276. doi:https://doi.org/10.3390/jcm14124276
36. Yuan N, Hu G, Bridwell KH, Koester LA, Lenke LG. How to determine the optimal proximal fusion level for Scheuermann kyphosis. European Spine Journal. 2024/03/01 2024;33(3):1021-1027. doi:https://doi.org/10.1007/s00586-023-08029-0
37. Debnath UK, Quraishi NA, McCarthy MJH, et al. Long-term outcome after surgical treatment of Scheuermann’s Kyphosis (SK). Spine Deformity. 2022/03/01 2022;10(2):387-397. doi:https://doi.org/10.1007/s43390-021-00410-7
38. Baymurat AC, Yapar A, Tokgoz MA, Daldal I, Akcan YO, Senkoylu A. Using Proximal Hooks as a Soft-Landing Strategy to Prevent Proximal Junctional Kyphosis in the Surgical Treatment of Scheuermann's Kyphosis. Turk Neurosurg. 2024;34(3):505-513. doi:https://doi.org/10.5137/1019-5149.Jtn.45194-23.2
39. Li Q. Surgical Procedures Used for Correction of Scheuermann’s Kyphosis: A Meta-Analysis. Pain Research and Management. 2021;2021(1):2142964. doi:https://doi.org/10.1155/2021/2142964
40. Polly DW, Jr., Ledonio CGT, Diamond B, et al. What Are the Indications for Spinal Fusion Surgery in Scheuermann Kyphosis? J Pediatr Orthop. May/Jun 2019;39(5):217-221. doi:https://doi.org/10.1097/bpo.0000000000000931
41. Green C, Brown K, Caine H, Dieckmann RJ, Rathjen KE. Prospective Comparison of Patient-selected Operative Versus Nonoperative Treatment of Scheuermann Kyphosis. J Pediatr Orthop. Sep 2020;40(8):e716-e719. doi:https://doi.org/10.1097/bpo.0000000000001576
42. Bennett DM. The Natural History of Scheuermann's Kyphosis. Journal of the Pediatric Orthopaedic Society of North America. 2025/11/01/ 2025;13:100263. doi:https://doi.org/10.1016/j.jposna.2025.100263
43. Ragborg L, Dragsted C, Dahl B, Gehrchen M. Scheuermann’s Kyphosis: a 39-year follow-up from diagnosis in non-operated patients. European Spine Journal. 2020/08/01 2020;29(8):2091-2099. doi:https://doi.org/10.1007/s00586-020-06384-w
44. Aulisa AG, Marsiolo M, Calogero V, Giordano M, Falciglia F. Long-term outcome after brace treatment of Scheuermann's kyphosis: an observational controlled cohort study. Eur J Phys Rehabil Med. Aug 2023;59(4):529-534. doi:https://doi.org/10.23736/s1973-9087.23.08070-x
45. Stone LE, Upasani VV, Pahys JM, et al. SRS-22r Self-Image After Surgery for Adolescent Idiopathic Scoliosis at 10-year Follow-up. Spine (Phila Pa 1976). May 15 2023;48(10):683-687. doi:https://doi.org/10.1097/brs.0000000000004620
46. Charalampidis A, Canizares M, Kalsi PS, et al. Differentiation of pain-related functional limitations in surgical patients with lumbar spinal stenosis (LSS) using the Oswestry Disability Index: a Canadian Spine Outcomes and Research Network (CSORN) study. Spine J. Apr 2022;22(4):578-586. doi:https://doi.org/10.1016/j.spinee.2021.10.008
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Hubert Jarosław Ćwiek, Marta Kołodziej-Sieradz, Anna Magdalena Terlecka, Paulina Klaudia Gryz, Kacper Komorowski, Karolina Jolanta Pilarska, Anna Aleksandra Szwankowska, Anna Baczyńska, Błażej Boruszczak, Adam Wiktor Rożenek
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Stats
Number of views and downloads: 18
Number of citations: 0
