Our 18-year old son has finally been diagnosed with Scheuermann’s disease after a long process. His spinal curvature has gotten worse in the last few years with a recent growth spurt. Is this likely to level off now? Or will he get worse as he gets older?

Scheuermann’s disease is characterized by a painful upper back fixed in a position of spinal forward curvature called kyphosis. It usually runs a fairly benign course. Symptoms go away when the patient stops growing and reaches skeletal maturity.

A special brace called a Milwaukee brace has been shown to help relieve pain and correct smaller curves as the child is growing. Even at age 18, your son may not be done growing. X-rays can be used to show if the growth plates have closed fully indicating the end of the growth phase.

Some studies have shown that curves can continue to get worse even after age 30. Treatment with surgery is advised for curves greater than 75 degrees. Surgery is also suggested for patients who are concerned about their appearance or who have pain or health issues. For example, heart and lung function can be impaired from the forward bent position of the spine keeping the chest from expanding.

Your orthopedic surgeon will be able to advise you in several ways. He or she will be able to assess your son’s growth potential. The degree of curve can be calculated from X-rays. Treatment is planned based on this measurement. The goal is to keep the curve from getting worse as the patient grows or ages. Bracing and spinal fusion are the two main ways to accomplish this.