- 期刊
Scheuermann 氏病引起之下背痛：病例報告
Low Back Pain Caused by Scheuermann's Disease: A Case Report
摘要
Scheuermann 氏病為引起青春期胸椎或胸腰椎結構性脊柱後彎(kyphosis)之原因之一。此病之真正病因學仍未確定，但有明顯的家族傾向。本文報告一位患有下背部疼痛之21歲男性，原被診斷為胸腰椎脊柱側彎(scoliosis)，經過門診復健治療後，症狀並未明顯緩解。經詳細檢查後發現，患者之第11、12胸椎及第1腰椎前方椎體呈楔狀變形合併脊柱後彎、胸腰椎脊柱側彎以及第5腰椎椎弓解離等異常。追蹤其家族史發現，患者母親於青春期開始出現駝背及背痛之情形，經門診X光檢查發現其胸椎亦有椎體變形、脊柱後彎及脊柱側彎等異常變化。綜合上述之檢查結果、家族史及臨床症狀，此病例疑為一家族型Scheuermann氏病。由於此疾病之臨床症狀不明顯，且治療時間的早晚，對其預後影響很大，因此希望藉此病例報告，對臨床同仁於診斷及處理此類疾病時，能有所助益。
並列摘要
Scheuermann's disease is one of the common causes of structural abnormality in the thoracic or thoracolumbar spines. Many theories have been proposed for the etiologies of Scheuermann's disease, but the true etiology remains unclear. The disease has a strong familial tendency which may be inh-erited in an autosomal dominant mode. This article describes a 21-year-old male patient who was suff-ering from low back pain for 2 years. The patient was initially diagnosed as having a scoliosis of the thoracolumbar spine. There was no symptomatic alleviation after initial rehabilitation therapy. Patient then received series of examinations, which revealed anterior wedge deformity of the T11, T12 and L1 spines together with kyphoscoliosis of thoracolumbar spine and L5 spondylolysis. In addition, patient's mother also had humpback and back pain since her adolescence, and her radiographic plain films showed an anterior wedge deformity, kyphosis and scoliosis of the thoracic spine. Because the clinical progress of the disease is insidious, early diagnosis and treatment become very important for the pro-gnosis of disease. Based on this case report, careful history taking and detailed examinations should be emphasized in patients inflicted with low back pain.