Children's Mercy

When the Spine Is Bent Out of Shape C urvature is the common denominator between scoliosis and kyphosis, but the conditions cause different abnormal contours. The spine develops an S-shaped curve with scoliosis, whereas it takes on an exaggerated rounded shape in the upper back with kyphosis. The conditions can occur together. Spinal deformities that affect most young people usually develop during the preteen and teenage years. Idiopathic scoliosis occurs due to unknown causes, although a child is more likely to have the condition if someone in her immediate family does. Kyphosis is caused by abnormal development of parts of the spine. "Children with kyphosis tend to have more back pain than children with scoliosis," says Nigel Price, MD, FAAP, FRCSC, Section Chief, Spine Surgery at Children's Mercy and Associate Professor of Orthopaedic Surgery at the UMKC School of Medicine. "This is particularly true with a type called Scheuermann's kyphosis, which makes the spine more rigid than the most common variety, postural kyphosis. Moderate to severe scoliosis, however, can cause discomfort and spine stiffness. Damage to self-esteem is also an issue for children with spinal curvature." Parents, it's time to bone up on two disorders that can throw your child's back health a curve: scoliosis and kyphosis. HELP IS HERE Scoliosis and kyphosis can be difficult to diagnose, especially if a patient has no pain or visible deformity. To check for these conditions, a physician performs a physical exam, takes a medical history and orders imaging studies to get a good look at the spine. The type of treatment recommended depends on the patient's age and degree of curvature. Mild curves typically get better without treatment. Moderate deformities, especially those in older children, often improve when patients wear a brace. Severe curves might require surgery to achieve more normal spinal alignment. "Children's Mercy is an early onset scoliosis center, meaning we offer special braces, casting techniques and surgical approaches for infants and young children, in addition to bracing and surgery for preteens and teenagers," Dr. Price says. "We want to allow patients to grow up normally—to play sports, pursue careers and have families." In short, spinal curvature shouldn't define children's futures. For more information about treatments for spinal deformities, visit www.childrensmercy.org/orthopaedicsurgery. Exercise? Go for It! Physical activity, while rarely a cure for spine problems, greatly benefits children's overall health and self-image. Physical therapy and back strengthening exercises are accepted treatments for postural kyphosis, a non-progressive spinal abnormality. Physicians and physical therapists sometimes prescribe a combination of breathing and back movement exercises to help patients adjust to wearing scoliosis braces. Both the National Institute of Arthritis and Musculoskeletal and Skin Diseases and the National Scoliosis Foundation state physical activity and team sports are safe for children with scoliosis. According to research, exercise will not cure or exacerbate the condition, but it will improve self-esteem, combat obesity and boost bone density. Follow us! www.childrensmercy.org 3

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