Kyphosis 

What is it?

Kyphosis comes from the Greek word for "hunchbacked." This condition is characterized as a curvature of the spine that is best seen from the side. In exams kyphosis is usually noted as a rounding of the upper back which results in poor posture. There is a normal amount of kyphosis (curvature) found in every spine. Spines that have a kyphotic curve of greater than 50 degrees are considered abnormal.

There are three general categories of kyphosis that appear in children:

• Postural kyphosis is the most common form - most people simply refer to it as slouching. It is more common in boys and most prevalent in adolescent years. The curve in the spine is normally flexible and causes no pain to the child, nor does it cause problems when the child is an adult. 
• Scheuermann’s kyphosis is caused by abnormalities on the growth centers of the vertebrae, where the front part of the spine doesn’t grow as quickly as the back part of the spine, causing the vertebrae to become wedge-shaped. This results in the child having a hunchback appearance. In this type of kyphosis the curve will usually become noticeable in the teen years and will worsen as the patient ages. Some children may have pain with this type of kyphosis near the worst part of the curve. 
• Congenital kyphosis develops while a child is in utero. During their fetal development, the bones of the spine may not form normally or some of the bones in the spine may be fused together. The child’s curve may worsen as he or she ages and may require surgery.

Why come to The Children’s Hospital for treatment of this condition?

Because children with kyphosis are usually still growing, it is important for them to be seen by a pediatric specialist, like the orthopedists at The Children’s Hospital who are familiar with how this condition changes as the spine grows. We care for infants, children and young adults with varying degrees of kyphosis and follow them throughout their growing cycles to ensure they are receiving the best treatment as their bodies grow and change.

Our pediatric orthopedic specialists are experienced when it comes to treating kids, because that’s what they do all day, every day. The Children’s Hospital Spine Program has a dedicated team of professionals who specialize in caring for all types of pediatric spinal deformities. The goal of our team is to provide the most conservative, yet most effective treatment possible for your child.

What are the signs and symptoms?

Children will often appear to have a “hunchback” and poor posture. Some patients with this condition will experience some amount of back pain.

How do you diagnose it?

Kyphosis is usually first discovered by a child’s primary care doctor during a routine physical examination. Sometimes a parent or family member may notice the increasing rounding of a child’s back and consider it poor posture.

If an increased kyphotic curve is noted, your child will likely be sent to a pediatric orthopedic specialist for evaluation and x-rays. X-rays of the spine will show the doctor the degree of the kyphotic curve and help determine if the curve is normal or abnormal and if there are any other abnormalities of the spine.

When your pediatric orthopedist examines your child’s spine, they will be able to determine if the curve is due to poor posture in the child, or if the curve is due to an abnormality in the vertebrae (congenital or Scheuermann’s kyphosis).

How do we treat it?

Treatment depends on the type of kyphosis a child has. 

If the patient has postural kyphosis , treatment is usually conservative and involves working with the child to improve posture through physical therapy, stretching and core fitness activities.

Those with Scheuermann’s kyphosis will often be treated conservatively as well with the same sort of exercises to enhance posture. In some cases, a back brace may be necessary to help support the spine. Surgery may be needed for larger curves or curves that show signs of continued progression.

In congenital kyphosis , surgery may be recommended to help maintain a more normal spine as the child grows.

Your orthopedic specialist will determine what type of kyphosis your child has and what the appropriate treatment option is for that.

Who gets it, and can it be prevented?

Kyphosis is generally more common in boys. As mentioned before, physical therapy and core fitness exercises for posture improvement can help prevent this condition from worsening.