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Kyphosis in Children

Overview

Kyphosis is a deformity of the backbone (spine). It's when the bones of the spine (vertebrae) in the upper back curve outward more than they should. A child with kyphosis has a back that is abnormally rounded or humpback. The condition is more common in girls than in boys.

A normal spine when looked at from behind appears straight. It can have a curve of 20° to 45° in the upper part of the back. With kyphosis, the curve can be 50° or more.

Causes

A child can be born with kyphosis. Or they can develop it because of other health reasons. These include:

  • Metabolic problems
  • Neuromuscular conditions
  • Brittle bone disease (osteogenesis imperfecta), which causes bones to break easily
  • Spina bifida
  • Scheuermann disease, which is caused by a structural abnormality in the spine. Three or more vertebrae are triangular shaped instead of rectangular shaped. This causes an exaggerated forward curve in the upper back.

Kyphosis can also be caused by slouching. In such cases, it is called postural kyphosis. This is the most common type. It's often first noticed in the teen years.

Kyphosis may also be a component of scoliosis. This is a disorder in which the spine has an abnormal curve.

Symptoms

These are the most common symptoms of kyphosis. Symptoms can occur a bit differently in each child. They can include:

  • Difference in shoulder height
  • Rounded shoulders
  • The head bends forward compared with the rest of the body
  • Difference in shoulder blade height or position
  • Upper back looks higher than normal when the child bends forward. A visible hump on the back is seen.
  • Tight muscles in the back of the thigh (hamstring)
  • Mild back pain
  • Fatigue

The symptoms of kyphosis may seem like other back problems. Or they may be a result of an injury or infection. Make sure your child sees their healthcare provider for a diagnosis.

Diagnosis

Your child's healthcare provider can diagnose kyphosis with a complete health history of your child, a physical exam, and certain tests. The provider will want to know if there is any family history of kyphosis. The provider will also ask about developmental milestones since some types of kyphosis can be linked to other neuromuscular problems.

Your child may need these tests:

  • X-rays. This test can make images of internal tissues, bones, and organs. It can measure the angle of your child's spinal curve. Treatment is often based on this measurement.
  • Bone scans. This test can rule out any infection or broken bones in your child's back.
  • MRI. This test uses a combination of large magnets, radiofrequencies, and a computer to make detailed images of organs and structures within the body. It can rule out any other problems of the spinal cord and nerves.
  • CT scan. This test uses X-rays and a computer to make detailed images of the body.
  • Blood tests . This test can check for infections or other causes of kyphosis.

Finding kyphosis early is important for successful treatment. If the condition is left untreated, it can lead to problems with lung function. Healthcare providers, and even some school programs, routinely look for signs of kyphosis in children. Your child may need some other tests, such as pulmonary function testing to see if there is any impact on your child's breathing.

Treatment

Treatment will depend on your child's symptoms, age, and general health. It will also depend on how severe the condition is.

The goal of treatment is to stop the curve from getting worse and prevent deformity. Treatment may include:

  • Observation and repeated exams. Your child will need to see their healthcare provider regularly. Whether the curve gets worse depends on the amount of skeletal growth, or how skeletally mature your child is. Curving of the spine often slows down or stops after a child reaches puberty. Pain is commonly treated with over-the-counter medicines, such as ibuprofen.
  • Exercises. If your child's kyphosis is because of slouching, certain exercises can fix their posture.
  • Bracing. If your child is still growing, they may need a brace for some time.
  • Surgery. In rare cases, your child may need surgery when the curve measures 75° or more and bracing has not slowed down the progression of the curve.

Key Points

  • Kyphosis is a problem with the spine. It's when the bones of the spine in the upper back curve outward more than normal.
  • A child can be born with kyphosis. Or they can develop it because of other health problems. Slouching can also lead to it.
  • A difference in shoulder height and a forward bent head can be signs of kyphosis.
  • Depending on the cause of kyphosis, your child may need a brace, exercises, or even surgery.

Next Steps

Tips to help you get the most from a visit to your child's healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child's condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child's healthcare provider after office hours. This is important if your child becomes ill and you have questions or need advice.