Scheuermann's Kyphosis: Diagnosis, Management, and Selecting Fusion Levels

J Am Acad Orthop Surg. 2019 May 15;27(10):e462-e472. doi: 10.5435/JAAOS-D-17-00748.


Scheuermann's kyphosis (SK) is a rigid structural deformity of the thoracic spine defined radiographically as three or more contiguous vertebrae with at least 5° of wedging anteriorly. Prevalence of the disease is thought to be between 0.4% and 10%. The true cause of SK remains unclear; however, various theories include growth irregularities, mechanical factors, genetic factors, and/or poor bone quality as the causes. Patients with mild disease (less than 70°) generally have a favorable prognosis with good clinical outcomes. Most patients with SK are successfully treated nonsurgically with observation, anti-inflammatory medications, and physical therapy. Surgical intervention is indicated in patients with greater than 70° to 75° thoracic curves, greater than 25° to 30° thoracolumbar curves, intractable pain, neurologic deficit, cardiopulmonary compromise, or poor cosmesis. Because of advances in posterior spinal instrumentation, surgery can typically be performed through a posterior-only approach. When surgical treatment is planned, appropriate selection of the upper- and lower-instrumented vertebrae is important to achieve a well-balanced spine, preserve motion segments, and reduce the risk of junctional kyphosis.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Conservative Treatment
  • Humans
  • Physical Therapy Modalities
  • Radiography
  • Scheuermann Disease / diagnosis*
  • Scheuermann Disease / etiology
  • Scheuermann Disease / pathology
  • Scheuermann Disease / therapy*
  • Spinal Fusion / adverse effects
  • Spinal Fusion / methods*
  • Thoracic Vertebrae / diagnostic imaging
  • Thoracic Vertebrae / pathology
  • Thoracic Vertebrae / surgery*


  • Anti-Inflammatory Agents