Beware! The secret behind children's "little hunchback"

Author: Shen Jianxiong, Chief Physician, Peking Union Medical College Hospital

Reviewer: Zhang Zhihai, Chief Physician, Guang'anmen Hospital, China Academy of Chinese Medical Sciences

In the process of children's growth and development, the health of the spine is particularly important. It is not only related to the child's body shape, but also directly affects their quality of life and health in the future. Congenital kyphosis, as a relatively common spinal abnormality, often makes parents worried.

In short, congenital kyphosis refers to the abnormal bulging of the spine toward the back during development, which exceeds the normal physiological curvature. Under normal circumstances, the human spine has an S-shaped physiological curvature when viewed from the side, including cervical lordosis, thoracic kyphosis, lumbar lordosis and sacral kyphosis. These curvatures together maintain the balance and motor function of the human body. However, when the thoracic or lumbar kyphosis angle increases abnormally, kyphosis is formed, commonly known as "hunchback".

Figure 1 Original copyright image, no permission to reprint

Congenital kyphosis can occur in any part of the spine, but is more common in the lower thoracic and lumbar regions. Kyphosis in these areas not only affects appearance, but may also cause compression of internal organs and the nervous system.

In-depth exploration of its causes shows that the occurrence of congenital kyphosis is mainly related to abnormal vertebral development, especially the presence of hemivertebra. Hemivertebra refers to the incomplete formation of a vertebra during development, resulting in partial or complete loss of the vertebra. When the hemivertebra is located at the lateral and posterior part of the spine, it will cause scoliotic kyphosis of the spine, that is, both lateral curvature and kyphosis. In addition, poor segmentation between vertebrae is also one of the causes of kyphosis, that is, two adjacent vertebrae fuse due to the formation of a bone bridge, causing the posterior vertebra to overgrow and the anterior vertebra to be restricted in growth, thus forming a hunchback.

Figure 2 Original copyright image, no permission to reprint

As the disease progresses, the symptoms of congenital kyphosis will become increasingly obvious. In the early stages, congenital kyphosis may only manifest as a slight protrusion in the appearance of the spine, which is not easy to detect. As the disease progresses, the child may experience symptoms such as back pain, abnormal posture, and limited spinal movement. More seriously, when kyphosis compresses the spinal cord or nerve roots, it can cause neurological symptoms such as lower limb weakness, numbness, urinary and bowel dysfunction, and even paralysis.

For children suspected of having congenital kyphosis, doctors usually first conduct a physical examination to observe the appearance and mobility of the spine. Further diagnosis requires imaging examinations, such as X-rays and CT three-dimensional reconstruction. These examinations can clearly show the structural abnormalities of the spine and provide a solid basis for diagnosis.

Congenital kyphosis not only affects the child's body shape and mental health, but more importantly, it may have a serious impact on his physical health. Long-term kyphosis can cause tension and strain on the muscles and ligaments around the spine, causing pain and dysfunction. More seriously, the compression of the spinal cord and nerve roots by kyphosis may cause irreversible nerve damage and paralysis.

The key to preventing congenital kyphosis is early detection and early intervention. Parents should pay close attention to their children's spinal development and seek medical attention in time if they find any abnormalities. In addition, maintaining good sitting, standing and sleeping habits is also an important measure to prevent spinal deformity. Appropriate physical exercise and outdoor activities can also help enhance the flexibility and stability of the spine.

It is worth noting that although scoliosis and kyphosis are both abnormal curvatures of the spine, they differ in morphology, causes, and clinical manifestations. Scoliosis is mainly manifested as an abnormal curvature of the spine in the horizontal plane, that is, the spine bends to one side; while kyphosis is mainly manifested as an abnormal bulge of the spine in the vertical plane. However, the two can sometimes exist at the same time, forming scoliotic kyphosis. This complexity makes the diagnosis and treatment of spinal deformity more challenging.