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Kyphosis

What is kyphosis?

Kyphosis is the forward curve in the middle of the spine, near the ribs. Here, the spine curves slightly outward, giving the back a gently rounded look. The normal range for this curve is 20 degrees to 50 degrees.

While some rounding is normal, doctors use the term kyphosis to refer to curves that are out of the usual range. You may also hear doctors call this hyper-kyphosis.

In children as well as adults, kyphosis can cause a humpback look. It can also be painful. In more serious cases, kyphosis can cause problems in the heart and lungs. It may make it more likely that your child will one day develop arthritis in his back.

There are several types of kyphosis:

Hyper-kyphosis

Hyper-kyphosis is an excessive roundness or a hump in the middle of the back.

Many teenagers slouch and look like they might have a hump, but this is not hyper-kyphosis. If you ask them to stand up straight, the hump may disappear. Some doctors call this slouching “postural roundback”.

Poor posture often worries parents, but it has not been shown to lead to any permanent back deformity.

Scheuermann kyphosis

In some rare cases, the bones of the back (vertebrae) do not grow correctly. In Scheuermann kyphosis, the front part of the vertebrae does not grow as well as the back part.

As your child approaches his teenage years, his back may become more curved and humped. Because the spine grows fast during these years, the vertebrae’s uneven growth can quickly lead to a deformity. The deformity, however, is rarely bad enough to require surgery.

Congenital kyphosis

Babies can be born with kyphosis. When the condition is present at birth (congenital), the bones in the back are shaped like wedges instead of the normal, round block shape. This may cause the spine to bend sharply.

In serious cases, the sharp bend in the spine can press on the spinal cord and cause paralysis of the legs. Young children or babies with congenital scoliosis have a higher risk of developing spinal cord problems.

How do you evaluate kyphosis?

Patterns of sagittal deformity.
Patterns of sagittal deformity.

During your child’s visit to our clinic, we will take X-rays of his backbone to look for the cause of kyphosis. X-rays also help us find out what type of kyphosis he may have.

If your child has congenital kyphosis, we usually will ask him to have an MRI to make sure that the curve is not pressing on the spinal cord.

As your child grows, we will take X-rays of his spine every three to four months so we can monitor changes in the curve. We also will check your child’s neurological function and his development.

Who gets kyphosis?

Both boys and girls get kyphosis. Postural kyphosis (roundback) is a mild curve that is more common in girls than in boys, and Scheuermann kyphosis is about twice as common in boys as it is in girls.

While babies can be born with kyphosis (congenital kyphosis), other forms of the problem often appear as children approach their teenage years.

Kyphosis is much less common than scoliosis.

What is your experience with kyphosis?

Our team is known nationally for treating all kinds of spinal deformities in children. Over its 12-year history, our team has treated hundreds of children with kyphosis.

Children with congenital kyphosis who have surgery have a chance of developing problems with their nervous systems. As a result, we make sure an experienced team of doctors specializing in the nervous system manages their care.

How do you treat kyphosis?

We use both surgical and non-surgical treatment.

Non-surgical treatment

In mild cases of Scheuermann kyphosis, exercises to strengthen the back can relieve the pain and fatigue that sometimes comes when children are active. However, studies have not shown that exercises affect the growth or development of the spine.

Back braces

If your child is still growing and has a mild case of Scheuermann kyphosis, wearing a back brace may stop the curve from getting worse.

At Children’s Hospital, our experienced team makes braces for children of all sizes and ages. Read about braces and our other orthotics and prosthetics services.

Surgery

If your child has more severe kyphosis — that is, a curve of 75 degrees or greater — we offer surgical treatment to correct the curve and stabilize his spine.

In this operation, the doctor anchors screws or hooks to your child’s vertebrae to attach them to a metal rod, and straightens the back.

Next, he fuses the spine by removing the joints between the bones. Finally, he places a bone graft next to the spine to help the bones grow together.

In severe cases, we use thoracoscopic techniques to release ligaments at the front of the spine. This makes your child’s spine more flexible.

In this operation, the doctor uses special equipment to view the procedure on a monitor. He works with tiny instruments that he inserts into your child’s chest through small incisions. This allows the doctor to correct the spinal deformity while at the same time using smaller incisions.

For congenital kyphosis, we often remove the deformed vertebrae to relieve pressure on the spinal cord that can cause paralysis. Next, we correct the spine deformity using metal rods and screws or hooks, as described above.

In these cases, our multi-disciplinary team includes doctors from neurosurgery to ensure the best possible results.