Kyphosis

Developmental Kyphosis

Nonsurgical Management

Observation
Observation is typically recommended in the following situations:

Postural hyperkyphosis (their round back straightens with proper posture),
Curves that are less than 60° in patients that are growing, or
Curves 60°-80° in patients that are done growing.

Standing, long-cassette (scoliosis) X-rays are taken every 6 months as the child grows. If the child has pain, an exercise program is usually recommended.

On the left is a side-view of a patient with Scheuremann’s kyphosis. On the right is the same X-ray after he was placed in a hyperextension brace.

Figure 1. On the left is a side-view of a patient with
Scheuremann’s kyphosis. On the right is the same X-ray
after he was placed in a hyperextension brace.

Bracing
When the deformity is moderately severe (60°-80°) and the patient remains skeletally immature, brace treatment in conjunction with an exercise program is the recommended treatment. Full time use of a brace (20 hours/day) is usually required initially until maximum correction has been achieved. The brace fit must be regularly evaluated and adjusted to ensure optimal correction. During the last year of treatment prior to skeletal maturity, part time brace wear (12-14 hours/day) may be proposed. Brace wear must be continued for a minimum of 18 months in order to maintain a significant, permanent correction of the deformity (Figure 1).

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