Spinal radiographs are sometimes taken with the patient erect and supine are helpful to document flexibility of a rigid deformity. Clinical Pertinent historical points include those previously mentioned for scoliosis assessment. Prominence of the patient's thoracic kyphosis or failure to reverse their lumbar lordosis with bend requires further investigation. This non-progressive condition is commonly seen in middle school children, especially girls, and almost always resolves by itself and requires no specific treatment. This localized deformity is usually painless.
Treatment is dependent upon the magnitude of the deformity, pain complaints and patient maturity.
Surgery is rarely required. A subtype of Scheuermann's disease occurs in the lumbar spine, usually in male patients during late adolescence who are involved in heavy lifting tasks. The changes of the vertebra and disc are considered to reflect the physical stress effects. Treatment is by elimination of the offending activity. Deformities due to congenital vertebral formation failure are predictably progressive and require early surgical treatment.