What Is the Difference Between Kyphosis and Scoliosis?

This disease is caused by the imbalance between the load capacity of the spine and the load it bears, also known as juvenile humpback or diabetic disease.

Basic Information

nickname: Juvenile hump
Visiting department: orthopedics
Multiple groups: 13 to 17 year old men

Common locations: vertebral
Common causes: Caused by an imbalance in the spine's load capacity and the load it bears
Common symptoms: Back pain and discomfort, difficulty in straightening, etc.

Causes of youthful hump

The etiology has not been clarified, and it is generally believed that the disease is caused by the imbalance between the load capacity of the spine and the load it bears. There are also reports related to genetic variation.

Clinical manifestations of youthful hump

Early symptoms include back soreness and discomfort, and a noticeable stiffness. Pain is located in the midline of the spine and is relatively mild with very little pain. Discomfort worsens after exertion and can be relieved by rest. Later, the thoracic kyphosis of the spine gradually increases, and it is difficult to straighten it. During the examination, it was found that the back was bulging backward in an arc shape, and passive and active activities could not change the kyphosis. The lordosis of the waist is compensatory, but the mobility of the waist is normal. In the later stages of the disease, the symptoms disappear and the kyphotic deformity of the thoracic spine always exists. Osteoarthritis of the spine occurs at an advanced stage.

Youth Sexual Humpback Examination

Vertebral wedge deformation is a basic feature of scheuermann disease, and there may be other characteristics, such as narrowing of the intervertebral space, schmorl nodules, narrowing of the vertebral endplate, irregularity or flatness, and anterior and posterior vertebral diameter increase.

X-ray performance: The typical X-ray performance can be divided into 3 stages. In the early stage, the vertebral body became wedge-shaped, with anterior low and posterior high, spot-shaped changes in the upper and lower condyles, rough upper and lower edges of the vertebral body, and slightly narrowed intervertebral space. In the middle period, the epiphysis was fragmented, and the normal shape of the upper and lower corners of the vertebral body disappeared. In the later period, the epiphysis returned to normal density, but the vertebral body showed a permanent wedge deformation. Schmorl nodules appeared in some cases, and an indented notch was found on the vertebral body on the radiograph. The vascular groove in front of the vertebral body is also one of the X-ray signs of the disease.

Youthful hump diagnosis

The diagnosis can be made based on the patient's age, gender, early weight-bearing history, and X-ray findings. In 1964, Sorenson first proposed the diagnostic criteria of X-ray imaging: at least 3 adjacent vertebrae of the thoracic spine had wedge changes of 5 ° or more.

Differential diagnosis of youthful hump

Need to identify the following diseases:

Active hump

Humpbacks can be corrected by the doctor's passive activities or the patient's active activities. For example, postural humpback is more common in adolescents due to poor posture; paralytic humpback is caused by hump of the trunk muscles due to a disease; compensatory humpback is often secondary to excessive lordosis of the lumbar spine. These humpbacks are characterized by a softer back, which can be deformed through movement, and there is no change in the epiphysis.

2. Fixed hump

Some disorders can be secondary to kyphosis, such as ankylosing spondylitis. The biggest difference from Scheuermann's disease is that ankylosing and deformities not only affect the thoracic spine, but also affect the entire spine. Accompanied by changes in laboratory tests. Spinal tuberculosis and spinal fractures can also cause humpback, which is characterized by an kyphosis of the back, rather than a symmetrical round back deformity like Scheuermann's disease. X-ray examination can make a clear diagnosis.

Youthful hump complications

May be accompanied by lordosis of the waist, kyphosis of the thoracic spine. Advanced osteoarthritis of the spine may be complicated.

Youthful hump treatment

The disease is mainly treated conservatively. Once the condition is diagnosed, the patient should be instructed to lie on a hard board. When standing and sitting, stretch the chest and back as much as possible and maintain a good posture. Avoid excessive bending or weight-bearing activities, and strengthen back muscles at the same time, hoping to increase the strength of the back muscles to limit the increase in kyphosis. For patients with more obvious pain, you can use traditional Chinese medicine to relieve spasm, relieve pain, and clear channels and collaterals to relieve symptoms.

The thoracic kyphosis is large. When it exceeds 50 °, it can be fixed with a stent or plaster to try to correct the deformity. The use of passive fixation to correct deformities should pay close attention to its complications, such as soft tissue damage, overcorrection, and concurrent scoliosis. Use a stent or plaster for at least 1 year.

Only a very small number of patients with severe kyphosis, accompanied by neurological symptoms or severe pain, should not be treated with surgery. The most commonly used method is spine fusion. In recent years, due to the development of instruments, posterior pedicle system and vertebral body resection (PSO, VCR technology) can be used to perform kyphosis orthopedic fusion.