Kyphosis in Children
What is kyphosis?
A normal spine, when viewed from behind appears straight. However, a spine affected
by kyphosis shows evidence of a forward curvature of the back bones (vertebrae) in
the upper back area. This gives the child an abnormally rounded or "humpback" appearance.
Kyphosis is defined as a curvature of the spine measuring 50° or greater on an X-ray
(a test that uses invisible electromagnetic energy beams to produce images of internal
tissues, bones, and organs onto film). The normal spine can bend from 20° to 45° of
curvature in the upper back area.
Kyphosis is a type of spinal deformity.
What causes kyphosis?
Kyphosis can be congenital (present at birth), or due to conditions that may include
Osteogenesis imperfecta (also called "brittle bone disease"). A condition that causes
bones to fracture with minimal force.
Scheuermann's disease. A condition that causes the vertebrae to curve forward in the
upper back area. The cause of Scheuermann's disease is unknown and is commonly seen
Postural kyphosis. The most common type of kyphosis. It generally becomes noticeable
in adolescence and can be associated with slouching versus a spinal abnormality. Exercise
is used to help correct posture.
Kyphosis is more common in females than males.
What are the symptoms of kyphosis?
The following are the most common symptoms of kyphosis. However, each child may experience
symptoms differently. Symptoms may include:
Difference in shoulder height
The head bends forward compared to the rest of the body
Difference in shoulder blade height or position
When bending forward, the height of the upper back appears higher than normal
Tight hamstrings (back thigh) muscles
Back pain, pain down the legs, and changes in bowel and bladder habits are not commonly
associated with kyphosis. A child experiencing these types of symptoms needs immediate
medical evaluation by a healthcare provider.
The symptoms of kyphosis may resemble other spinal conditions or deformities, or may
be a result of an injury or infection. Always talk with your child's healthcare provider
for a diagnosis.
How is kyphosis diagnosed?
The healthcare provider makes the diagnosis of kyphosis with a complete medical history
of the child, physical exam, and diagnostic tests. The healthcare provider obtains
a complete prenatal and birth history of the child and asks if other family members
are known to have kyphosis. The healthcare provider also will ask about developmental
milestones since some types of kyphosis can be associated with other neuromuscular
disorders. Developmental delays may need further medical evaluation.
Diagnostic procedures may include the following:
X-rays. A diagnostic test that uses invisible electromagnetic energy beams to produce images
of internal tissues, bones, and organs onto film. This test is used to measure and
evaluate the curve. With the use of a full-spine X-ray, the healthcare provider measures
the angle of the spinal curve. A determination for treatment can often be made based
on this measurement.
Bone scans. A nuclear imaging method to evaluate any degenerative and/or arthritic changes in
the joints; to detect bone diseases and tumors; to determine the cause of bone pain
or inflammation. This test is to rule out any infection or fractures.
Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets, radiofrequencies,
and a computer to produce detailed images of organs and structures within the body.
This test is done to rule out any associated abnormalities of the spinal cord and
Computed tomography scan (also called a CT or CAT scan). This is an imaging test that uses X-rays and a computer to make detailed images of
the body. A CT scan shows detailed images of any part of the body, including the bones,
muscles, fat, and organs. CT scans are more detailed than general X-rays.
Early detection of kyphosis is important for successful treatment. Pediatricians or
family healthcare providers, and even some school programs, routinely look for signs
that kyphosis may be present.
Treatment of kyphosis
Specific treatment for kyphosis will be determined by your child's healthcare provider
Your child's age, overall health, and medical history
The extent of the condition
Your child's tolerance for specific medicines, procedures, or therapies
Expectations for the course of the condition
Your opinion or preference
The goal of treatment is to stop the progression of the curve and prevent deformity.
Treatment may include:
Observation and repeated exams. The child will need observation and repeated exams. Progression of the curve depends
on the amount of skeletal growth, or how skeletally mature, the child is. Curve progression
usually slows down or stops after the child reaches puberty.
Bracing. If the child is still growing, the healthcare provider may prescribe a brace. The
type of brace and the amount of time spent in the brace will be determined by your
child's healthcare provider.
Surgery. In rare instances, surgery is recommended when the curve measures 75° or more on X-ray
and bracing is not successful in slowing down the progression of the curve.
Long-term outlook for a child with kyphosis
The treatment of kyphosis is individualized for each child. It depends on the diagnosis,
his or her age, amount of curvature, and amount of time remaining for skeletal growth.
Kyphosis will require frequent exams by your child's healthcare provider to monitor
the curve as your child grows and develops. Early detection is important. If left
untreated, kyphosis can lead to problems with lung function.