Spinal Deformities in Children: What Parents Should Know

What is spinal deformity in children?

Spinal deformity in children is a condition where the spine is having an abnormal curve or alignment. The spine may curve sideways like an “S” or "C," hunching forward in the upper back, and curve inward instead of outward in the lower back.

These abnormal spinal curves can vary from mild to severe and can interfere with the child's growth. In cases of severe deformities, this condition can alter the shape of the spine and chest, which may impact breathing and lung development.

To help manage this condition, early detection and treatment are important. Parents can play a role by scheduling regular medical check-ups to monitor the kids spinal development, particularly during growth spurts.

Spinal deformity causes in children

A healthy spine in children should have three natural spine curvatures, forming a gentle S-shape when viewed from the side and appearing straight when viewed from behind.

However, several conditions can cause unusual curvatures that affect posture and movement during early or late childhood, as well as before birth. Conditions that can cause spinal deformities in children include:

1. Congenital spine deformities:

   • Congenital spine deformities are present at birth due to improper development of bones or vertebrae during pregnancy, often resulting from conditions such as spina bifida.

2. Neuromuscular disorders:

   • Neuromuscular disorders, which affect nerves and muscles, can impair muscle control and strength, leading to spinal deformities. 

   • This deformity can be caused by conditions such as cerebral palsy and Duchenne muscular dystrophy.

3. Diseases:

   • Certain diseases, such as osteoporosis, cancerous spinal tumours, and non-cancerous spinal tumours, can increase the risk of spinal deformities in children.

4. Weak abdominal muscles:

   • Weak abdominal muscles can increase a child's likelihood of developing spinal deformities, as they may struggle to support the spinal cord's weight. 

5. Poor body posture:

   • Poor posture habits, like slouching, can weaken spinal muscles and contribute to abnormal curvature. 

   • This is more common in children who spend excessive time sitting or using electronic devices.

6. Overweight:

   • Being overweight can strain the lower back and pull it forward, increasing the risk of lordosis, a condition characterised by an excessive inward curvature of the lower spine.

7. Genetics: 

   • A family history of spinal issues can increase the risk of spinal abnormalities, particularly idiopathic scoliosis.

8. Injuries or infections: 

   • Spinal injuries, such as fractures, can alter the spine’s alignment. Similarly, infections like osteomyelitis (bone infection) can damage vertebral structures and lead to an abnormal spinal curve.

9. Idiopathic spinal deformities:

   • Idiopathic spinal deformities occur without a known cause and are not linked to any underlying disease.

10. Other factors: 

    • Nutritional deficiencies, such as insufficient calcium and vitamin D, can weaken bones and contribute to spinal alignment issues.

Types of spinal deformities in children

There are several types of spinal deformities that can affect children, including:

• Scoliosis

  • Scoliosis is the most common type of spinal deformity, characterised by a sideways curve of the spine, usually in an "S" or "C" shape. This condition usually occurs in children ages 10 to 15.

  • There are 3 forms of scoliosis, such as idiopathic, neuromuscular, and congenital scoliosis. This deformity can occur from conditions like cerebral palsy or Duchenne muscular dystrophy.

• Kyphosis

  • Kyphosis is a condition characterised by an unnatural forward curve of the upper spine, which appears as a hunched back or a bowed posture.

  • This spinal deformity can occur due to poor posture, congenital issues, or Scheuermann's disease, which affects spinal cord growth.

• Lordosis

  • Lordosis, also referred to as swayback, is an abnormal inward curvature of the lower back that results in an abdominal bulge. This condition can also occur in the cervical region of the spine, causing the neck to abnormally extend forward.

  • It's often seen in children with neuromuscular disorders but may also result from factors such as poor posture or obesity.

• Congenital spine deformities

  • These pediatric deformities are present at birth and usually caused by the improper formation or segmentation of vertebrae during foetal development.

Common symptoms of spinal deformity in children

The symptoms of a spinal deformity in children may vary depending on the location and severity of the condition. But in general, there are several physical signs  that parents should watch out for, including:

1. Uneven shoulders

   • One shoulder may appear higher than the other, and the shoulder blades may protrude unevenly.

2. Difficulty standing straight

   • The child may lean to one side and have a hard time maintaining an upright posture. They also looked leaning to one side when standing or walking.

3. Ribcage asymmetry

   • One side of the ribcage could stick out more than the other.

4. Head misalignment

   • The child's head may appear misaligned with the body, leaning noticeably to one side.

5. Noticeable hump or curve

   • When viewed from behind, the spine may have a visible curve or a noticeable hump as the child bends forward.

6. Back pain

   • During physical activities, the kid may feel back pain, which ranges from mild to severe.

7. Difficulty with physical activities

   • Spinal stiffness or persistent pain can make it difficult for the child to perform daily activities, such as walking.

8. Fatigue

   • Prolonged muscle strain from abnormal curvature can lead to fatigue, particularly during physical activities.

9. Lung function impairment

   • In severe cases, spinal deformities may compress the lungs, leading to impaired lung function.

Recognising these symptoms early can help prevent the deformities from worsening and reduce persistent pain, allowing children to return to their daily activities as soon as possible. 

If you notice any of these symptoms in your child, don’t hesitate and request an appointment with Thomson Medical for comprehensive assessments and personalised care plans to support your child’s health and well-being.

Diagnosis of spinal deformity in children

To diagnose the spinal deformity in children, the doctor may check the kid’s family history and do a physical exam. During this assessment, the doctor will look for visible signs of spinal curvature, uneven posture, and muscle weakness.

Additionally, the doctor may also do Adam's forward bend test, where the child bends forward, to help identify any abnormal curves or asymmetries in the spine.

To help healthcare professionals understand the condition better and see if there’s any other underlying conditions, imaging tests may be done. Procedures such as X-rays, MRI (magnetic resonance imaging), or CT (computed tomography) scans can provide detailed views of the spine and help assess the degree of curvature.

Treatment options for spinal deformities

The treatment for spinal deformities in children depends on the severity of the curvature, its location in the spine, the child’s age, and the condition's progression.

Treatment approaches are divided into two categories, nonsurgical treatment and surgical treatment, which include:

Nonsurgical treatment

• Observation:

  • For mild spinal deformation (less than 20°), especially in younger children, the doctor may recommend regular monitoring to see if the spine curvature worsens over time.

• Bracing

  • To prevent moderate curvature (20–40°) from worsening as the child grows, bracing is often used. This treatment is effective when the child is still growing and the spine curvatures are progressing.

  • Braces are usually worn for 18–20 hours a day but can be removed for sports or other activities.

• Physical therapy

  • Physical therapy can help strengthen the muscles surrounding the spine, improve posture, and increase flexibility. 

  • It is often recommended as a complementary treatment, especially for children with mild deformities or those who are using a brace.

Surgical treatment

Surgical correction may be performed if the spinal bones are curving more than 50°, compressing other organs, or if there's persistent pain that does not respond to nonsurgical treatments.

The goal of surgery is to straighten the spine, stabilise it in the new position, and prevent further progression of the curvature. Two common surgical procedures include:

• Spinal fusion:

  • This spinal surgery is the most common procedure, where the spine is permanently stabilised and straightened using rods, screws, or bone grafts.

• Growing rods:

  • This spinal surgery procedure may be used in younger children to allow for continued growth while correcting the spinal curvature. The implant can be adjusted and lengthened every few months as needed.

Spinal deformity prevention

Some spinal abnormalities, particularly congenital kinds, are unfortunately difficult to prevent. However, parents can take proactive actions to lower the children's chance of developing postural abnormalities or worsening an existing condition:

• Encourage good posture: 

  • Teaching children to maintain good posture while sitting, standing, and carrying items can help avoid straining the spine.

• Physical activity: 

  • Regular exercise and physical activity, particularly those that strengthen the back and core muscles, can help maintain spinal posture.

• Proper backpack use: 

  • Ensure children use both straps on their backpack and avoid carrying overly heavy loads to reduce strain on the spine.

• Pre-pregnancy checkup:

  • Some spinal deformities, such as scoliosis, can run in families. To reduce the likelihood of children having this condition, a pre-pregnancy checkup is recommended.

  • This examination helps ensure the mother’s overall well-being before conception and identify any underlying health issues that might impact the pregnancy.

FAQ

What are the three types of spinal deformities?

Three types of common spinal deformities in children are as follows:

• Scoliosis, which is characterised by a sideways curve of the spine, usually in an "S" or "C" shape. 

• Kyphosis, an unnatural forward curve of the upper spine, which appears as a hunched back.

• Lordosis, or swayback, is an abnormal inward curvature of the lower back that results in an abdominal bulge.

What are spinal cord abnormalities in children?

Spinal cord abnormalities in children are a condition where the spine has an abnormal curve or alignment in adolescence. 

The spine may curve sideways like an “S” or "C," hunching forward in the upper back, and curve inward instead of outward in the lower back.

How do you treat spinal deformities?

There are two types of treatment approaches for spinal deformities. The first one is nonoperative treatments, which include using a brace and physical therapy.

The other is a surgical correction, which may be performed if there is severe pain despite treatment, spinal bones are compressing other organs, or spine curvature continues to worsen.

How can parents help children with spinal curvature?

Parents can play an important role in managing and supporting their child's spinal condition, such as:

• Teaching good posture habits, such as sitting up straight, avoiding slouching, and using backpacks correctly.

• Encourage regular physical activity, like swimming, yoga, or sports, to strengthen back muscles and improve flexibility.

• Help maintain a balanced diet to avoid excessive weight gain, which can reduce strain on the spine.

Can a child with spinal curvature participate in sports?

Yes, most children with mild to moderate spinal curvature can enjoy sports and physical activities. Low-impact exercises like swimming, cycling, or walking are particularly beneficial for strengthening back muscles and improving posture. 

But, for severe cases or after surgery, consult a doctor for guidance on activity levels and avoid high-impact or strenuous sports as advised.

Is it possible to correct spinal deformities?

Yes, spinal deformities can often be corrected or improved through treatments such as bracing, physical therapy, or surgery, depending on the severity and underlying cause of the condition. Early intervention usually leads to better outcomes.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice, please consult a specialist at Thomson Medical. Request for an appointment with Thomson Medical today.