The vulnerable, rapidly growing thoracic spine of the adolescent

The upper and lower surface of the vertebral bodies are covered with a thick cartilaginous plate in which the secondary ossification centres develop at puberty and continue to grow throughout adolescence. Congenital indentations in the cartilaginous plates are not uncommon and they constitute regions of diminished resistance, which yield under physical stress. Prolapse of disc tissue occurs into the vertebral body, causing a disturbance of growth but little if any pain. The vertebrae in the mid-thoracic region become wedge-shaped, and a kyphotic deformity results, the so-called Scheuermann's disease, or adolescent kyphosis. A plea is made for the screening of children exposed to risk.