DEAR DR. GOTT: My grandson, who is 15, was just diagnosed with type II Scheuermann disease of the spine. This was discovered when he had X-rays following a minor mo-ped accident. His doctor has prescribed a muscle relaxant and an anti-inflammatory, along with having him go to physical therapy. What can you tell me about this disease? Will he need to be on medication the rest of his life? Is there a cure for it? What is the cause, and is it hereditary?
His mother has a Harrington's rod on her spine for scoliosis. Thank you for any information you can provide.
DEAR READER: Scheuermann's disorder of the spine is more commonly known as adolescent kyphosis, a humplike curvature caused by the wedging together of several vertebra in a row. This can occur when the front of the upper spine fails to grow at the same rate as the back of the spine. Normal thoracic curvature is between 20 and 50 degrees. Scheuermann kyphosis is diagnosed if three or more adjacent vertebrae have wedged at least 5 degrees. While rare at birth, it can occur at any age. When it occurs in adults, it can be the result of a fracture, the slipping of one vertebra forward on another, specific connective tissue disorders, endocrine disease, Paget's disease, tumors, spina bifida and several other causes.
Diagnosis can be made through examination by a physician and X-rays of the spine. When a tumor or neurological symptoms are present, a physician may choose to order an MRI for confirmation.
Treatment depends on the specific reason for the disorder. If a tumor or infection is involved, surgery may be recommended. If pain and pronounced curvature is involved, a brace and physical therapy might be appropriate. Congenital forms might require corrective surgery at a young age. If degenerative joint disease is involved or if there are numerous compression fractures, surgery may be necessary to reduce the level of pain and correct the deformity.
Scheuermann's isn't a disease, nor is it contagious. The good news is that the disorder ceases when an adolescent stops growing. My guess is that his doctor is well informed and is providing appropriate care.
DEAR DR. GOTT: Regarding SLS-free toothpaste, the Tom's of Maine I recently bought does contain this substance. My chief complaint is dry lips. This means I'm constantly using lip gloss. Biotene toothpaste is the only one I have found to be SLS free that solves my dry lip problem.
DEAR READER: SLS (sodium lauryl sulfate) is a highly effective chemical found in industrial products used to remove oil stains and residue. In lower degrees of intensity, it is found in toothpaste, shampoos, conditioners and other products. The Biotene to which you refer, and Tom's Spearmint Paste, are SLS free. Biotene contains aloe leaf juice, which might help your dry lips, but Tom's contains glycerin as a moistener.
Because SLS can cause mouth irritation, some manufacturers offer alternatives, but it isn't a necessary component.
Write to Dr. Gott, c/o NEA-United Media, 200 Madison Ave., Fourth Floor, New York, N.Y. 10016.