Pediatric scoliosis and kyphosis are abnormal curvatures of the spine diagnosed in children. Neither is life-threatening, but both can impact the development of back muscles and spinal tissue in growing children and teens. Symptoms can often be managed with minimally invasive treatments. However, regular screening is important to catch the conditions early. Children and teens with scoliosis or kyphosis who get treatment early can typically live normal, healthy lives.
Wellness & Prevention
There’s no solution to completely prevent scoliosis or kyphosis in children. These conditions generally occur from abnormal development of spinal tissues at birth. They can also occur from complications related to other medical problems, such as spina bifida or cerebral palsy.
Regular health screenings are performed on children and teens to detect any abnormal curvatures in the spine. If unusual curvature is found, doctors will begin treating the symptoms to ensure the child’s healthy development as he or she grows.
There are three types of scoliosis that commonly occur in children:
- Congenital scoliosis is present at birth. This form is rare.
- Idiopathic scoliosis is the most common type of scoliosis in children and teens. The exact cause is unknown, but is thought to be based in genetic factors.
- Neuromuscular scoliosis is caused by the muscles and nerves that support the spine. For example, a child with cerebral palsy may end up with scoliosis due to the impact on muscle development.
There are also three types of kyphosis that can occur in children:
- Postural kyphosis happens when bones and muscles develop abnormally, possibly due to poor posture. It is the most common form of kyphosis and is usually noticeable during adolescence.
- Scheuermann’s kyphosis also develops during adolescence but is less common. It results from a structural deformity in the vertebrae.
- Congenital kyphosis is present at birth. Vertebrae can be fused together or bones can form improperly.
The majority of scoliosis and kyphosis cases in children are found during routine screenings. These are often performed at schools. However, the Adams Forward Bend Test, which is the most popular screening method, may not catch all scoliosis cases.
Another reason childhood scoliosis or kyphosis can go undetected is because symptoms can be so mild that they’re often missed. Warning signs that parents and caregivers should look for include:
- Often leaning to one side
- Uneven shoulders or leg length
- One or both shoulder blades stick out
- Elevated hips
- Uneven waistline
- Abnormal rounding of upper back
If scoliosis or kyphosis is suspected, further diagnostic tests may be performed. A full medical history will be taken. This includes asking questions about a family history. A detailed picture of the spine may be needed for a more accurate diagnosis. One or more of the following imaging tests may be done:
- Spine X-rays can provide a picture of the vertebrae. This allows doctors to measure the degree of curvature.
- An MRI scan offers a detailed image of the spinal cord, cartilage and ligaments. This test can show if there are other conditions causing the curvature, like a cyst or tumor. It can also detect if the spinal cord is attached to the bony part of the spine.
- A bone age study uses X-rays of the wrists, hands or other parts of the body to study the growth plates. Results from this study can help doctors to predict if the curvature will get worse as well as which treatments may help.
If a spinal curve is greater than 25 degrees, treatment may be recommended.
There is no cure for scoliosis or kyphosis, but early treatment can manage symptoms and help prevent further spinal curvature. With treatment, the majority of children with scoliosis or kyphosis can go on to live happy, normal lives. In many cases, symptoms are so mild that no additional treatment is needed other than regular doctor visits.
There are many factors to consider in deciding the best treatment:
- Your child’s age
- Family history of scoliosis or kyphosis
- The type of scoliosis or kyphosis
- The degree and location of the curvature
Treatment often begins with simply monitoring the condition to check progression. This means visiting the doctor every four to six months. Regular checkups are necessary to track the condition severity and rate of spine curvature. If it’s noticed that your child’s spine is worsening, your doctor may recommend other treatment options.
If the curve is pronounced or advancing quickly, your doctor may recommend noninvasive constructive care such as bracing or physical therapy. A back brace can help the spine straighten out and develop normally. Physical therapy focuses on strengthening the core muscles to provide support to the spine and improve posture. Physical therapy can also help to increase flexibility, improve range of motion and reduce pain.
If your child is a good candidate for growth preservation techniques, your doctor may recommend procedures that can correct the curve of the spine and encourage normal growth. Procedures may include the use of grow rods, a vertical expandable prosthetic titanium rib (VEPTR), the SHILLA system, vertebral stapling, video-assisted thoracoscopic surgery (VATS) or extreme lateral interbody fusion (XLIF).
If your child has a severe spinal curve or has not shown progress from wearing a brace, your doctor may recommend scoliosis surgery to correct the spine. Spine reconstruction can be in the form of MIS posterior surgery, open surgery or a Ponte procedure.
A child with scoliosis or kyphosis can face many physical, emotional and social challenges. Many children are self-conscious about wearing back braces at school or around their peers, and may be resistant to treatment. If symptoms are painful, living with curvature of the spine can feel discouraging.
When caught early, symptoms are often manageable. However, untreated pediatric scoliosis or kyphosis can lead to problems related to the heart and lungs. Having your child regularly screened is an important part of maintaining good health and providing the best possible care.