Kyphosis 

What is it?

Kyphosis – spinal curvature or rounding of the back – is usually noted on exam as a rounding of the upper back which exaggerates poor posture. This is usually seen when looking at your child from the side view. 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.

How is it Diagnosed?

Kyphosis is usually first seen by your primary care doctor when examining your child’s spine at a routine yearly physical. Sometimes a parent or family member may notice the increasing rounding of the 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 him or her determine if that curve is normal or abnormal, and if there are any other bony abnormalities of the spine.

Are there Different Types of Kyphosis?

Yes. 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 Kyphosis or Scheuermann’s Kyphosis).

Postural Kyphosis

This is the most common type of kyphosis and most people simply refer to it as slouching. It is more common in girls than boys and is most noticeable 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. There is no treatment for postural kyphosis, but exercises may be given to you by your doctor for strengthening.

Congenital Kyphosis

This type of kyphosis occurs when the child is still 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 as they grow. If this occurs, the child may develop a kyphotic curve that worsens as he or she ages. The treatment for this type of kyphosis will usually require surgical intervention. 

Scheuermann’s Kyphosis

In this type of kyphosis the curve will usually become noticeable in teen age years and will worsen as the child ages.  The vertebrae in the spine are become wedged shaped and thus cause the worsening curve. Some children may have pain with this type of kyphosis at the worst part of the curve or apex. To help relieve this pain, your doctor may prescribe exercises and anti-inflammatory medicines. A back brace may also be prescribed and as a last option, surgery may be necessary.

What is the treatment for Kyphosis?

As noted above the treatment depends on the type of kyphosis. If the patient has postural kyphosis, treatment is usually conservative and involves improving one's posture.

Those with Scheuermann’s kyphosis will often be treated conservatively as well with the exercises and anti-inflammatory medications. A back brace may be necessary to help support the spine. Finally, surgery may be needed if the curve is greater than 75 degrees.

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

Your Orthopedic doctor will help you discover what type of kyphosis your child has and what the appropriate treatment option is for that.