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Figure 1: An MRI of a young boy
with a congenital dislocation of
the spine causing severe
kyphosis. The spinal cord (light
grey) is tented over the
dislocation.

Kyphosis

Congenital Kyphosis

Evaluation

On X-Ray, normal vertebrae are close to rectangular in size when viewed from the side. Thoracic vertebrae are somewhat smaller in the front than the back (to create kyphosis), while lumbar vertebrae are the opposite to create lordosis. Congenital kyphosis creates more kyphosis than expected for the particular region of the spine.

As with congenital scoliosis, there is potential for defects in other organ systems. After X-rays confirm the diagnosis, the physician may order additional tests to determine if occult abnormalities are present in the spinal cord, kidneys, cardiac or gastrointestinal system. The MRI provides additional information regarding the abnormal growth potential and may assist in predicting progression of the spinal deformity (see Figure 1).

From a clinical perspective, it is important to monitor the child’s leg strength and ability to walk. More severe kyphosis can place significant pressure on the spinal cord causing myelopathy (spinal cord compression). Young children may be perceived as being late walkers when they actually have spinal cord compression. In most instances, however, there is not significant pressure on the nerves.

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Kyphosis