Kyphosis in the Pediatric Patient

Diagnosing Kyphosis

The origin of the Kyphosis can be idiopathic (of unknown origin), congenital (present at birth) or neuromuscular (related to the nerves and muscles). Abnormal development of the spinal column in the womb characterizes congenital kyphosis. The vertebrae may be formed abnormally or may be fused together. Surgical intervention is frequently required in order to prevent progressive deformity as well as to prevent injury to the spinal cord.

Kyphosis is diagnosed in children with a forward curve of greater than 45 degrees.

Children with kyphosis who are able to straighten up to normal posture are considered to have flexible round back deformity. In such cases the pediatric orthopedist may recommend physical therapy to strengthen the back muscles.

In cases where the x-ray shows specific vertebral body changes, the child may be diagnosed with Scheuermann’s kyphosis. This condition usually appears in adolescence. Scheuermann’s kyphosis is marked by the presence of vertebral wedging in three or more vertebrae in a row, which can be seen on a lateral (side-view) x-ray.

 

Treating Kyphosis

In a growing child, treatment of Scheuermann’s kyphosis with a spine brace may be effective. However, if the deformity continues to progress—reaching 70 degrees or greater—and the child has finished growing, surgical intervention is an option. In such cases, instrumentation is used to bring the spine into alignment, and bone grafts are made to maintain the correction of the spine.