Schulman disease
Introduction
Introduction to Schulman's disease Scheuermann's disease is a stiff kyphosis (humpback) deformity common in the thoracic or thoracolumbar segments of adolescents. Most children diagnosed before skeletal maturity can be successfully corrected with a brace. However, this disease is often confused with postural hunchback and cannot be detected in time, so that hunchback deformity and persistent back pain are discovered or confirmed, thus delaying the optimal prevention time. Surgical treatment is required when the deformity is severe, especially if non-surgical treatment does not relieve pain. Under normal circumstances, Seheuermann's disease is a benign developmental disease, and there are few people with severe malformations and clinical symptoms. In the adolescent growth period, untreated Scheuermann's disease can progress to progressive structural kyphosis, especially in growth. In the process of trauma and overwork, common back pain and fatigue often disappear naturally after the bone matures. If the final kyphosis does not exceed 75°, in addition to back pain, the patient generally does not have long-term discomfort, and the back The pain is often mild and few are disabled. basic knowledge The proportion of illness: 0.001% Susceptible people: no special people Mode of infection: non-infectious Complications: pulmonary failure
Cause
The cause of Shullman's disease
The etiology and pathogenesis are still unclear.
Prevention
Schulman disease prevention
There is no effective preventive measure for this disease. Early detection and early diagnosis are the key to the prevention and treatment of this disease.
Complication
Swellman's disease complications Complications, pulmonary failure
Severe kyphosis of the disease can cause pulmonary dysfunction, spinal cord compression, and even severe paralysis of the lower extremities.
Symptom
Schulman's disease symptoms common symptoms thoracolumbar back diffuse low back pain compensatory lumbar lordosis spinal cord compression palpe lower lumbar pain
Chelate deformity
As the disease begins in adolescence, and the chest or thoracolumbar kyphosis occurs, family members often think that it is caused by bad posture, which is a common cause of delay in diagnosis and treatment. At this time, patients may have obvious chest and back pain. It can be aggravated by standing and intense physical activity. After the growth stops, the disease will stop developing, and most of the pain will disappear automatically. However, when the deformity is severe, the patient may also have lower back pain.
2. Lumbar lordosis
In addition to the thoracic kyphosis, the patient also has varying degrees of (compensatory) lumbar lordosis. For the thoracic segment, the head and neck also protrude forward. The excessive lordosis of the lumbar spine is actually a severe kyphosis of the patient. Compensation for the sake of it.
3. Other symptoms
(1) Neurological symptoms: severe kyphosis can cause compression of the spinal cord, and severe cases may even have paralysis of the lower extremities.
(2) Low back pain: When the lesion affects the lumbar vertebrae, the patient often has low back pain, which is common in male athletes and mountainous people, indicating that the development and deterioration of the disease is the result of repeated trauma and intense exercise.
Examine
Swellman's disease check
X-ray imaging diagnostic criteria for Scheuermann's disease include:
Wedge vertebral body
The vertebral body has a wedge-shaped appearance, and at least three or more vertebral vertebral vertebral vertebral bodies are in the diseased stage, and the angle formed by the adjacent wedge-shaped vertebral bodies should generally exceed 5°.
2.Schmorl nodule
This is another imaging feature of the disease. The vertebral endplate is irregular or flat, the intervertebral space is narrow, the nucleus pulposus can protrude into the upper and lower vertebral cartilage plates, and the anteroposterior diameter of the apical vertebra increases. The imaging changes of individual patients are limited to In the apical vertebra, the changes in the upper and lower vertebral bodies are very slight; for such cases, attention should be paid to the exclusion of other diseases.
3. Neck, lumbar lordosis
In addition to the standing lateral radiograph showing excessive kyphosis of the thoracic vertebrae, abnormalities such as excessive lordosis of the lumbar spine and increased lordosis of the cervical spine can be found at the same time.
In fact, the deformity of the neck and lumbar vertebrae is not structural, but a compensatory change to the thoracic kyphosis, which is related to maintaining the balance of the vertebral body in the sagittal plane.
Diagnosis
Diagnosis and identification of Shuller disease
The diagnosis of this disease is mainly based on:
History
Slow onset from childhood, mainly chest and back discomfort and pain.
2. Malformation
Mainly for round back deformity, the neck and waist can be forwardly convex.
3. Imaging findings
More than 3 wedge-shaped vertebral bodies in the apical vertebrae, more visible Schmorl nodules.
