Juvenile osteochondrosis of the spine

Juvenile osteochondrosis of the spine is designated in ICD-10 by the code M42.0. Its other names: osteochondropathy of the vertebral apophyses, aseptic necrosis of the vertebral apophyses, Scheuermann-Mau disease, osteochondropathic kyphosis, juvenile kyphosis. The disease occurs more often in young men during the period of growth of the body, at the age of 11-18 years.

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Causes of juvenile osteochondrosis of the spine

The causes of dorsal juvenile kyphosis are not fully understood. There are currently many theories about this disease. The Danish orthopedic surgeon Scheuermann, after whom the disease is named, believed that the cause of spinal deformation is avascular necrosis of the endplates of several vertebral bodies.

Other researchers believe that the spinal deformity is caused by a disruption in the ossification processes of the cartilaginous matrix in the endplates of several vertebral bodies. It is possible that disruptions in the structure of muscle tissue also play a role in the genesis of the disease. All researchers recognize the importance of hereditary predisposition to the disease.

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Symptoms of juvenile osteochondrosis of the spine

During juvenile osteochondrosis of the spine, three stages are distinguished depending on the age and activity of spine growth. The initial stage manifests itself in the period of immature vertebra, the peak stage - in the period of synostosis of apophyses and the stage of residual phenomena - in the period of ossification of apophyses. The severity of the lesion depends on: the angle of kyphosis of the thoracic spine (45° or more), the number of affected vertebrae, the degree of their deformation and the severity of pain syndrome. The disease is often combined with endocrine disorders.

Patients complain of spinal deformity, rapid fatigue, weakness of the back muscles, pain in the left side. Clinical examination reveals increased thoracic kyphosis, the apex of which shifts caudally, the kyphosis is arcuate and smooth in shape. In the lumbar region, lordosis increases in depth. Spinal mobility is significantly limited.

X-ray examination is performed in two standard projections with radiation centered on the apex of the kyphotic deformity.

Radiographs show wedge-shaped deformation of the bodies of the apical vertebrae, fragmentation of the apophyses, changes in the endplates (tortuosity, discontinuity, serration). The intervertebral discs at the level of kyphosis are changed in the form of rounded depressions in the area of the endplates of the bone of the overlying and underlying vertebrae (Schmorl's cartilaginous nodes). The ossification points of the vertebral apophyses are frayed, often enlarged. There are almost always lateral deviations of the spinal axis in the lumbar region, but the arc of scoliosis does not exceed 10-15°.

Treatment of juvenile osteochondrosis of the spine

The most effective are long-term and systematic treatment, therapeutic exercises that do not provoke pain syndrome, swimming, massage and unloading the spine. In addition, it is recommended to wear a corset with a pad at the top of the deformation in the area of the affected vertebrae in the position of hyperextension of the spinal column.

Another component of conservative treatment is complex drug and physiofunctional therapy to normalize blood circulation and muscle tone, eliminate pain syndrome and stimulate osteoregeneration. With early treatment, it is possible to stop the development of the disease and the formation of deformation. The prognosis for this disease is favorable.