When a normal spine is viewed from behind, it generally appears straight. However, spine which is affected by kyphosis shows evidence of forward curvature of vertebrae (back bones) within the upper back region. This in effect will give the person a ‘humpback’ or abnormally rounded appearance. Kyphosis is medically defined as a spinal curvature measuring 50 degrees or more on an x-ray test using invisible electromagnetic energy beams for producing internal images of tissues, organs & bones. On the other side, a normal spine can only bend between 20 – 45 degrees of curvature within the spine’s upper back region. Pediatric kyphosis therefore is a very special type of spine deformity.
Kyphosis may either be present at birth (congenital) or may be caused due to conditions including the following.
- Metabolic problems
- Spina bifida
- Osteogenesis imperfect (‘brittle bone disease’). This is a condition which causes bones to fracture at minimal force.
- Neuromuscular conditions
- Postural kyphosis – This is one of the most common types of kyphosis. It is generally noticeable in adolescence & is usually associated with a spinal abnormality called slouching versus. However, exercise can often be used to help correct posture.
- Scheuermann’s disease – This is a condition which causes vertebrae to curve forward within the upper back region. Cause of Scheuermann’s disease is however unknown. It is most commonly seen in males.
Generally, kyphosis is more common in females than in males.
Following is a list of the most common signs & symptoms of kyphosis. However, each child may experience signs & symptoms quite differently.
- Difference in height of shoulders
- Head appears to bend forward when compared with rest of the body
- Difference in shoulder blade position or height
- Height of upper back appears slightly higher than normal when patients bend forward
- Tight back thigh (hamstrings) muscles
However, back pain & pain down the legs or changes in bladder & bowel habits are not so commonly associated with kyphosis. Children experiencing these symptoms will require immediate medical evaluation by healthcare professionals. Moreover, signs & symptoms of kyphosis may resemble many other spinal deformities of conditions or may in cases result from infection or injury. Parents should make it a point to talk to doctors for a diagnosis.
Doctors make diagnosis of kyphosis with help of diagnostic tests, physical examination & complete medical history of child, including prenatal & birth history. They will also enquire whether any other family members are known to be having kyphosis. Doctors will also enquire about developmental milestones since quite a few types of kyphosis are associated with neuromuscular disorders. Developmental delays may also require further medical evaluation as well.
- Observation & Repeated Examinations – Children with kyphosis will require observation & repeated examinations. Progression of curvature will depend upon the amount of skeletal growth & skeletal maturity of the child. Curve progression is usually found to slow down or stop after the child has reached puberty.
- Bracing – Doctors usually prescribe a brace in case the child is still growing. Type of brace & the amount of time the child will have to spend within brace will also be determined by the doctor.
- Surgery – Surgery is recommended in rare instances when the curvature is measuring 75 degrees or more on x-ray imaging & when bracing has not proved to be successful in slowing progression of curve.
Treatment of kyphosis is individualized for every child. However, this will depend upon the diagnosis, age of the child, amount of curvature & amount of time which is left for skeletal growth of the patient. Moreover, kyphosis cases require frequent examinations by doctors to monitor curvature as children grow & develop. Early detection is therefore important & in case kyphosis is left untreated it can also lead to problems developing with lung functions. Orthopaedic Surgery India is ideally associated with the best pediatric doctors & surgeons in the country along with scores of accredited multispecialty hospital facilities in order to provide the most affordable treatment packages to international patients.