Lumbar Scheuermann

Definition

 

Different entity to thoracic Scheuermann's

- end plate abnormal but no kyphosis or wedging

 

Natural History

 

Self - limiting condition

 

Epidemiology

 

Young athlete / labourer

 

Symptoms

 

Adolescent who presents with low grade levels of low back pain

- more pain than thoracic

 

Signs

 

Rigid marked flattening of the lumbar lordosis 

- hypolordotic

 

Flattening not reversible by hyperextension

- hamstring spasm common

- no lumbar wedging

 

Limbus Vertebrae 

- anterosuperior pseudofractures of the body

 

Xray

 

Diagnostic Criteria

 

1. Irregular endplates

2. Schmorl nodes - diagnostic

3. Disc narrowing

4. No wedging or kyphosis

 

Large defects of the lower thoracic & lumbar vertebral bodies at their anterosuperior borders 

- focal enlargement of vertebral bodies is noted occasionally

- defects anterosuperior bodies resolve, but some kyphos remains

 

Management

 

Respond to TLSO with moulded lumbar lordosis for 12/12 & activity modification

 

No long term sequelae