Spinal Disorders in Children: Causes, Diagnosis, and Treatment

What are spinal disorders in children?

Spinal disorders are abnormalities that affect the spinal column’s development, alignment, or function. These issues can range from mild and temporary to severe health conditions. These disorders may involve the bones, muscles, nerves, or connective tissues of the spine, potentially impacting a child’s growth and overall health. Early detection and treatment are crucial for preventing long-term complications and ensuring proper spinal development.

Learn more about spinal curvatures here.

Common spinal disorders in children 

Spinal disorders in children refer to a range of spinal conditions affecting the development, alignment, or function of the spine. These problems can vary from mild to severe and may impact a child’s growth, mobility, and overall health. Here are some common types of spinal issues in children:

1. Scoliosis

   • Scoliosis is a spine condition where there is an abnormal curvature in the spine, causing it to curve sideways, forming an "S" or "C" shape.

   • Commonly detected during adolescence and may require bracing or corrective surgery depending on the severity.

   • Children with severe scoliosis can undergo a surgical treatment where growing rods are implanted into their spines by spine surgeons to correct the spinal curve and allow for continued growth.

2. Kyphosis

   • Kyphosis is a condition where there is an excessive outward curve of the upper back, leading to a hunched posture.

   • Can result from poor posture (postural kyphosis) or conditions like Scheuermann’s disease.

3. Lordosis

   • Lordosis is a condition characterised by an exaggerated inward curve of the lower spine, also known as swayback.

   • Symptoms include back pain, balance problems, and a pronounced spinal arch, with treatments ranging from physical therapy to surgery in severe cases.

4. Spondylolysis and spondylolisthesis

   • Spondylolysis: A stress fracture in one of the vertebrae.

   • Spondylolisthesis: When a vertebra slips over the one below it.

   • Often caused by repetitive stress on the spine from sports like gymnastics, football, or weightlifting.

   • Common symptoms may include lower back pain, stiffness, loss of function, and difficulty with movement.

5. Spinal infections

   • Includes conditions like osteomyelitis (infection in the bone) and discitis (infection in the spinal discs).

   • Common symptoms include severe back pain, fever, and difficulty moving. Early diagnosis and treatment with antibiotics are crucial.

6. Spina bifida

   • A birth defect where the spine and spinal cord don't form properly, leaving part of the spinal cord exposed.

   • Types of spina bifida:

     • Spina bifida occulta: The mildest form, often asymptomatic.

     • Meningocele: Involves a bulging of the spinal cord’s protective membranes.

     • Myelomeningocele: The most severe form, where the spinal cord and nerves are exposed and damaged.

   • Treatment often involves surgery soon after birth and ongoing therapy to manage complications.

7. Flatback syndrome

   • A condition where the normal curvature of the lower spine (lumbar lordosis) is lost, resulting in a flat back.

   • Symptoms include back pain, difficulty standing upright, and fatigue due to compensatory posture.

8. Torticollis (wry neck)

   • Characterised by a tilted head due to tight muscles on one side of the neck.

   • Can be congenital (present at birth) or acquired through muscle strain or trauma.

   • Treatment includes physical therapy, stretching exercises, or surgery in severe cases.

9. Cervical spine issues

   • Problems in the neck area of the spine caused by congenital abnormalities, muscle imbalances, or trauma.

   • Symptoms may include neck pain, restricted movement, or neurological issues like tingling or weakness.

10. Congenital abnormalities

    • Includes missing vertebrae, fused vertebrae, or abnormal spinal curvatures present at birth.

    • These conditions can lead to structural instability or developmental delays if untreated.

Do you think that you might be suffering from one of the common injuries above? Request an appointment with our specialists at Thomson medical today for an accurate diagnosis and an individualised treatment plan.

Causes of spinal disorders in children 

Spinal disorders in children can stem from various factors, including genetic conditions, lifestyle habits, and medical disorders. Understanding these causes can help parents and caregivers identify potential issues early and seek appropriate treatment.

1. Genetic factors:

   • Inherited spine conditions like scoliosis, Marfan syndrome, Ehlers-Danlos syndrome, or muscular dystrophy can cause muscle weakness and weaken the spine’s structure, increasing the risk of curvature or deformities.

2. Congenital abnormalities:

   • Birth defects such as spina bifida or congenital scoliosis impact the development and alignment of the spine.

3. Neuromuscular conditions:

   • Neuromuscular disorders like cerebral palsy, muscular dystrophy, and spinal muscular atrophy can cause muscle imbalances and poor spinal alignment.

   • These conditions affect how muscles and spinal nerves function, often leading to spinal deformities.

4. Growth spurts:

   • Rapid growth during adolescence (ages 10–15) can cause the spine to curve unpredictably, a condition known as adolescent idiopathic scoliosis (AIS).

   • Since pubertal growth spurt happens quickly, spinal curves may worsen without proper monitoring.

5. Postural issues:

   • Poor posture, such as slouching, carrying heavy backpacks, or prolonged sitting, can strain the spine and lead to deformities like postural kyphosis or lordosis.

   • Weak core muscles and lack of physical activity further contribute to poor posture and back pain.

6. Injury or trauma:

   • Accidents or injuries to the spine can result in fractures, dislocations, or herniated discs, affecting spinal alignment and stability.

7. Nutritional deficiencies:

   • Deficiencies in vitamin D or calcium can lead to bone conditions like rickets or osteopenia, making the spine more vulnerable to deformities and fractures.

8. Infections and tumours:

   • Infections like osteomyelitis, discitis, or meningitis, though rare, can damage the spine.

   • Tumours, whether benign (e.g., neuroblastoma) or malignant (e.g., osteosarcoma), may lead to spinal deformities and compromise neurologic function.

9. Environmental factors

   • Incorrect backpack use, poor sleep positions, or extended periods of poor posture can strain the spine and contribute to back or neck problems.

10. Endocrine disorders

    • Hormonal imbalances, such as hypothyroidism or growth hormone deficiencies, can disrupt normal bone growth and weaken spinal alignment.

Symptoms of spinal disorders in children

Spinal problems in children can present through a variety of symptoms, ranging from pain to noticeable deformities. Here are some signs of spinal issues in children:

1. Back pain: 

   • Persistent or unexplained pain in the back or neck, often worsening after physical activity, prolonged sitting, or upon waking.

2. Poor posture: 

   • Slouching, leaning to one side, or an unusual stance may indicate an underlying spinal issue.

3. Fatigue: 

   • Difficulty maintaining proper posture or discomfort from spinal deformities can cause tiredness, especially during physical activities.

4. Limited mobility: 

   • Reduced ability to move the neck, back, or limbs, with challenges in bending or turning the head or spine.

5. Difficulty walking: 

   • Issues with balance, coordination, or walking may occur due to spinal misalignment affecting spinal nerves.

6. Visible deformities: 

   • Abnormal curves, uneven shoulders, or a hump in the back can signal structural spinal problems.

7. Fever: 

   • A sign of spinal infection, such as osteomyelitis or discitis, which requires immediate medical attention.

If your child experiences any of these symptoms, especially persistent pain, visible deformities, or difficulty walking, request an appointment with us for evaluation and diagnosis. Early intervention can prevent further complications and support healthy spinal development.

How to diagnose spinal problems in children

Orthopaedic specialists often classify spinal cord injuries into 2 main types:

• Complete injury: There is no movement or feeling at all below the point of injury.

• Incomplete injury: There is still some residual feeling or movement below the point of injury.

Diagnosing spinal problems in children involves a combination of diagnostic tools and imaging tests to identify abnormalities and determine the best course of treatment. 

Common types of diagnostic methods include: 

1. Physical examination

   • A healthcare provider evaluates the child’s underlying condition such as posture, spinal symmetry, and flexibility.

   • They may check for uneven shoulders, abnormal curves, or asymmetries in the back.

2. X-rays

   • X-rays are a commonly used imaging test used to measure the degree of spinal curvature and assess overall alignment.

   • These images help diagnose spinal curvatures like scoliosis, kyphosis, or lordosis.

3. MRI or CT scans

   • Advanced imaging techniques, such as magnetic resonance imaging (MRI) or CT scans, are used in cases where structural abnormalities or impairment of neurologic function are suspected.

   • These scans provide detailed views of soft tissues, nerves, and bones to help identify complex conditions.

At Thomson Medical, our paediatric specialists provide advanced diagnostic tests and personalised care for children with spinal problems. Request an appointment with us for expert support in your child’s spinal health journey.

Treatment options for spinal disorders in children 

Spinal disorders in children can arise from congenital anomalies, developmental conditions, or acquired issues due to injury or disease. Early detection and appropriate treatment are essential to ensure optimal growth and prevent long-term complications. The treatment options for spinal disorders in children depend on the specific condition, severity, and the child’s overall health. 

Observation and monitoring

For mild spinal conditions, doctors may recommend regular monitoring through X-rays and check-ups to track any changes. This is particularly common for conditions like mild scoliosis or kyphosis.

Non-surgical treatments

1. Bracing: 

   • Often used to prevent progression of spinal curvatures like scoliosis. Braces such as the TLSO are worn daily to stabilise the spine.

2. Physical therapy: 

   • Strengthens muscles, improves posture, and enhances flexibility, providing non-invasive management of spinal issues.

3. Pain management: 

   • Medications like NSAIDs may be used for pain relief in more severe cases.

Surgical treatments

In severe cases or when non-surgical methods fail, surgery may be necessary:

1. Spinal fusion: 

   • Common for severe scoliosis and kyphosis, where vertebrae are fused to correct curvature.

2. Growing rod surgery: 

   • Used for young children, allowing for spinal growth while managing deformities.

3. Vertebral body tethering (VBT): 

   • A minimally invasive procedure for scoliosis to control spinal growth.

Other treatment options

1. Emerging therapies:

   • Innovative treatments, like 3D-printed braces and biological therapies (e.g., stem cell treatment), show promise in improving spinal disorder management for children.

2. Multidisciplinary care:

   • Effective treatment often involves a team of specialists, including paediatric orthopaedic surgeons, physical therapists, and pain management experts.

Concerned about your child’s spinal health? Request an appointment with us today to schedule a consultation and take the first step towards your child’s well-being.

FAQ

When should I seek medical help for my child's spine?

You should consult a doctor if your child shows any of the following signs:

• Persistent back pain: Unexplained or worsening pain in the back or neck.

• Visible deformities: Curved spine, uneven shoulders or hips, or a noticeable hump in the back.

• Neurological symptoms: Numbness, weakness, difficulty walking, or changes in coordination.

• Bladder or bowel changes: Loss of control, which may indicate impairment of neurologic function.

• Signs of infection: Fever, pain, or swelling in the back.

• Breathing issues: Difficulty breathing or chest tightness linked to spinal abnormalities.

• Posture problems: Difficulty standing upright, walking, or noticeable changes in gait.

Can poor posture cause spinal problems in children?

Yes, poor posture can contribute to certain spinal problems, particularly postural kyphosis, which results in a rounded back. While poor posture may worsen conditions like kyphosis or lordosis, it is not usually the sole cause of structural spinal deformities such as scoliosis. Encouraging good posture during activities like schoolwork or screen time is essential to prevent unnecessary strain on the spine and promote overall spinal health.

Can spine problems be cured?

The possibility of curing spine problems in children depends on the specific spine condition, its severity, and the timing of intervention. Many spinal problems can be effectively managed or corrected with treatments like physical therapy, bracing, or surgery. Conditions such as postural kyphosis often improve with posture correction and exercises, while more severe issues like scoliosis or congenital abnormalities may require surgical intervention. Early diagnosis and treatment significantly improve outcomes, making it essential to address spine problems promptly.

What are the most common spinal abnormalities in children?

The most common spinal abnormalities in children include:

• Scoliosis: A sideways curvature of the spine forming an "S" or "C" shape.

• Kyphosis: An excessive forward curvature of the upper back, resulting in a hunched posture.

• Lordosis: An exaggerated inward curve of the lower back, also called swayback.

• Spina bifida: A congenital defect where the spinal cord doesn’t fully develop or close properly.

• Flatback syndrome: Loss of the natural curve of the lower spine, leading to a flat back.

What is the most common spinal injury in children?

The most common spinal injury in children is a vertebral fracture, typically in the cervical spine (neck), caused by trauma from falls, sports, or accidents. Adolescents are more prone to thoracic and lumbar spine injuries, especially from high-impact sports or activities.

How do I know if something is wrong with my spine?

Signs that something may be wrong with your spine include:

• Persistent back pain: Pain that doesn’t improve with rest or worsens over time.

• Visible abnormalities: Uneven shoulders, a curved spine, or a hump in your back.

• Limited mobility: Difficulty bending, twisting, or moving your neck or back.

• Neurological symptoms: Numbness, tingling, weakness, or difficulty walking.

• Postural changes: Slouching, leaning to one side, or difficulty standing upright.

• Other symptoms: Loss of bladder or bowel control or fever with back pain, which may indicate a serious issue.

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.