The term “kyphosis” refers to part of the contour of the upper (thoracic) spine. When viewed from the side, most people have an outer sway (kyphosis) in the upper spine, and an inner sway (lordosis) in the lower spine.
Excessive thoracic kyphosis, a condition common in adolescents, gives people a “humpbacked” appearance.
Postural kyphosis (postural roundback), often leads to excessive thoracic kyphosis. The condition frequently develops from poor posture or unequal muscle strength, especially after a sudden growth spurt. Postural kyphosis is flexible, meaning an affected child can correct their posture by pulling their shoulders back and “sitting up straight.”
One of excessive thoracic kyphosis’s rarer causes is Scheuermann disease. Children with this disease have some wedge-shaped back bones (vertebrae); typically, vertebrae are square-shaped. The misshapenness creates a rigid position that cannot be corrected by adjusting posture.
Children with postural kyphosis often have no concerns about their backs — generally, patients’ parents bring their concerns about their child’s poor posture to medical professionals’ attention. However, some children may complain of nonspecific, occasional back pain.
Children with Scheuermann disease more commonly experience back pain. The pain tends to worsen with prolonged sitting, standing or running, and it cannot be consciously corrected with good posture.
Your doctor will evaluate your child’s back and spine, and they may ask your child to bend over and touch their toes so the spine’s curvature can be examined. Your doctor may also decide to take x-rays to evaluate the spinal structure.
Postural kyphosis doesn’t require any treatment and will resolve on its own over time. If the kyphosis is especially severe or bothersome, your doctor may prescribe physical therapy or a brace to help with muscle strength and flexibility.
Scheuermann disease treatment depends on the case’s severity and the child’s symptoms. Observation is appropriate for children and teens with milder kyphosis and those who have not experienced significant back pain, and physical therapy may be useful to help lessen back pain. Growing children with moderate to severe Scheuermann disease are candidates for bracing to prevent the condition from worsening, but spinal fusion surgery is rarely required for children with severe cases and pain.