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Scheuermann's disease of the thoracic spine is a well-defined entity, although its exact etiology is unknown. In the thoracolumbar or lumbar spine however, the criteria are much less strict for the application of this eponym. A retrospective review of all the cases of lumbar Scheuermann's disease seen at the Texas Scottish Rite Hospital revealed two distinct radiographic pictures. These consisted of a “classic” Scheurermann's and an “atypical” type characterized by vertebral end plate changes, disc space narrowing, and anterior Schmorl's nodes, but not otherwise fulfilling Sorenson's criteria. This group tended to occur in more athletic adolescents or those with a history of increased axial stress to the spine. A subgrouping of atypical Scheuermann's disease is proposed and includes acute traumatic intraosseous disc herniation. Based on these findings, a classification of lumbar Scheuermann's disease is proposed.