Paediatric Kyphosis

A structural kyphosis is a posterior convex deformity of the spine that may appear in childhood and worsen with growth. The most common type is known as Scheuermann’s disease which defines a rigid abnormal curvature of the thoracic and/or thoracolumbar spine. This pathological kyphosis should be differentiated from a rounded postural kyphosis that tends to correct spontaneously with physical therapy. The aetiology of Scheuermann kyphosis remains unclear and probably is multifactorial. Natural history is usually favourable, and the treatment relies on non-operative measures in the overwhelming majority of cases. Surgery is reserved for severe rigid kyphosis in older children and for cases with refractory pain or neurological deficits. Advances in contemporary spinal posterior instrumentation techniques have considerably reduced surgical risks and avoided the indications for anterior approaches.