Kyphosis in Children – Adolescents
What it is
Kyphosis in Children – Adolescents
Kyphosis, scoliosis and lordosis are the most common types of spinal deformities. Kyphosis is an abnormal forward curve in the upper spine. Children with kyphosis have a rounded or “hunchback” appearance. While some children are born with kyphosis, most cases develop during adolescence.
Some degree of front-to-back curve of the spine is normal and healthy. However, if a child’s spine curves forward 50 degrees or more, they should be seen by a spine specialist.
Kyphosis typically develops in the thoracic region of the spine. In rare cases, it can occur in the cervical spine. The most common type is Scheuermann’s kyphosis or juvenile kyphosis.
There are two types of kyphosis:
- Postural kyphosis is the most common, and usually least serious, type of kyphosis. It becomes noticeable in adolescence. Poor posture, including slouching in front of a computer for long periods, can increase the risk that a child’s spine and surrounding muscles will not develop properly. Postural kyphosis is not a structural deformity, not painful, and most often does not get worse over time. The forward curve is rounded. If asked to stand up straight, a teen with postural kyphosis can do so.
- Scheuermann’s Kyphosis or Juvenile Kyphosisis usually more severe, more rigid, and more deforming than postural kyphosis. It is a structural abnormality that occurs when several vertebrae in the thoracic spine develop a triangular (rather than rectangular) shape. The wedge-like shape causes the spine to bend forward at a sharp angle. A teen with Scheuermann’s kyphosis cannot correct their curve by trying to stand up straight.
Kyphosis can also be caused by fractures, infections, bone abnormalities or Hurler syndrome.
What are the main symptoms?
Some kyphosis symptoms are visible to the naked eye. Other symptoms are not visible but can make a child with kyphosis uncomfortable.
Visible kyphosis symptoms include:
- Visible hump, typically in the upper back
- Upper back appears higher than normal when bending forward
- Head always or almost always bent forward
- Excessive rounding of the shoulders
- Difference in the height or position of the shoulders or shoulder blades
Children with severe kyphosis may have one or more of the following symptoms:
- Tight muscles in the backs of their thighs (hamstrings)
- Back pain and stiffness
- Trouble breathing
- Extreme fatigue
- Forward shoulder movement
- Crouching posture
- Back pain
Kyphosis in Children – Adolescents:
Why is early diagnosis and treatment important?
If a child is diagnosed with kyphosis, it would be good to be monitored regularly by the doctor as this condition may cause problems in the proper functioning of the musculoskeletal system and pain or discomfort in the spine. These problems, in children, can significantly impact their growth, development and the quality of their everyday life and their life as adults as they can accelerate the normal wear and tear of the spinal column.
What can I do if my child shows symptoms of kyphosis?
Your pediatrician is the first person that you should consult so that he/she can take a full medical history of the child and perform a clinical examination. If the doctor notices any alarming symptoms, then he/she will refer the child to a specialized spine surgeon in scoliosis to carry out an accurate diagnosis and complete investigation and evaluation of the condition.
Simple monitoring is usually needed but each case is unique and therefore an individualized approach is required.
Kyphosis in Children - Adolescents: How is diagnosed?
At first, the doctor will take a complete medical history and continue with a clinical examination of the child. The Spine Surgeon will send the patient for X – rays. These are necessary to see if there is a kyphosis and how bad it is. The Spine Surgeon will measure the angle of the kyphosis on the X – ray (Cobb angle). For more detailed diagnosis and depending on the case, other imaging tests (such as an MRI or a CT scan) may be done to get more detailed information about the child’s spine.
How is kyphosis treated in children and adolescents?
Regular Follow- up & Monitoring
Usually kyphosis is a condition that is treated with regular follow-ups and monitoring by a Spine Surgeon through 6-9 monthly appointments. When pain is observed, anti-inflammatory or painkillers are recommended. If kyphosis remains the same whenever your child goes for an appointment, the doctor will keep monitoring the condition until your child reaches adulthood (16-18 years old).
The beneficial properties of physical exercise
It is good to take care of your good physical condition as it works helpfully in the case of kyphosis. There are currently no official studies proving that physical activity can prevent the development of kyphosis, but it certainly helps in the proper functioning of the body. Physical therapists provide exercise regimens and therapies to address the muscular imbalance associated with kyphosis. Exercises can help strengthen your child’s core, upper back, shoulders, and shoulder blades.
Can back braces help?
The effectiveness of the back braces depends on whether the child is able to follow the doctor’s instructions. The back braces are usually rigid and need to be worn 23 hours a day as, in this way, they are more effective. They can be worn under the clothes. The child can take the back brace off to eat, dress and wash.
When is surgery necessary?
The most common operation for kyphosis is a posterior instrumented correction and fusion. This means an operation through a long scar on the back of you, to put rods and screws into the bones of your spine and straighten your spine. This operation also involves using some form of bone graft to fuse the spine to stop your curve deteriorating or coming back. The aim of the operation is to straighten the spine. Before surgery, your Spine Surgeon will take the medical history and inform you about this procedure. Then he/she will talk to you about the risks and benefits of this type of operation and the post-operative stage.
