Kyphoscoliosis

Kyphoscoliosis is a condition characterized by the abnormal alignment of the spine. It can be seen in all the age group, but more common in children, below the age of 16 years that is before the puberty. In the majority of the patients, the mobility of the vertebrae is decreased significantly, interfering the active strengthening of the spine. Get to know more details about the causes, diagnosis, and treatment options available to treat Kyphoscoliosis.

Let’s look into more details about Kyphoscoliosis

kyphoscoliosis

Mostly, the kyphoscoliosis cases are mild, but some children develop spinal deformities that become more severe as they grow. A severe spinal curve can decrease the amount of space within the chest, making it difficult for the lungs to function properly, and also cause disability of the patient. A kyphoscoliosis spine looks like the letter ‘C’ or ‘S,’ when it is viewed from the front or back; whereas, normal spine looks straight from the same view.

The children with mild kyphoscoliosis are monitored by taking X-rays to see if the curve is getting worse. Usually, the patients with mild kyphoscoliosis do not need any treatment. However, in some cases, the doctors may advise wearing a brace to prevent the curve from getting worse, whereas, some cases with severe deformity needs surgery to straighten the spine.

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What are the causes of kyphoscoliosis?

Some of the possible causes of kyphoscoliosis are:

  1. Idiopathic:

This type of scoliosis is commonly seen in 80% of the cases without any specific cause.

  1. Defect from birth:

This kind of scoliosis is rare and occurs due to the congenital (from birth) deformity of the spine.

  1. Neuromuscular issue:

20% of the cases are caused by neuromuscular type conditions such as cerebral palsy (CP) or muscular dystrophy.

  1. Length of the leg:

If the length both the legs is not symmetrical, it can lead to kyphoscoliosis.

  1. Heredity:

It occurs due to the involvement of the gene – GPR126.

  1. Other:

Poor posture, carrying heavy weights, and doing wrong exercise, can also cause kyphoscoliosis.

Back Rest for proper posture correction at workplace

How will you know that your child has kyphoscoliosis?

If your child has the following symptoms, then visit your doctor:

Signs of Kyphoscoliosis

  • Uneven shoulders
  • Uneven waist
  • Shoulder blade that appears more prominent than the other
  • A hip higher than the other

If the curve worsens, it will also make the spine rotate or twist, which may impact on the ribs on one side, protruding it forward more than the other side. As a result, the patient has pain and difficulty in breathing.

What are the risk factors of kyphoscoliosis?

Risk factors for developing the most common type of kyphoscoliosis includes:

  • Age:

Signs and symptoms scoliosis usually begin to occur during the growing stage of the children, just before the puberty, between the ages of 9 to 15 years.

  • Sex:

Girl Childs has a much higher risk of worsening curve and requires treatment.

  • Family history (hereditary):

Kyphoscoliosis can be hereditary, but most children with scoliosis have no family history of the disease.

How is kyphoscoliosis patient diagnosed?

First of all, the physician will take the detailed medical history, and may ask some related questions about the recent growth of the child to her/his parents. During the physical examination, the doctor may ask your child to stand and then bend forward from the waist, hanging the arms freely, to see if one side of the chest is more prominent than the other.

Your spine specialist may also perform a neurological examination to check the following things:

  • Muscle weakness
  • Numbness
  • Abnormal reflexes

Tests:

A plain radiograph can help confirm the diagnosis of scoliosis and reveal the severity of the curvature of the spine. If the doctor suspects any underlying problem, like a tumor – is causing scoliosis, he/she will recommend for the additional imaging tests, which may include;

  1. MRI (magnetic resonance imaging): MRI uses radio waves and a powerful magnetic field to produce detailed images of bones and soft tissues.
  2. CT (computed tomography): CT combined X-rays taken from many different directions to produce images with more details than the plain radiograph does.
  3. Bone scan: Bone scans involve injecting a radioactive material that travels to the parts of the bones that are injured or in the healing process.

As mentioned above, many children with scoliosis have smooth curves and probably may not need the treatment with a brace or surgery. Children who have mild kyphoscoliosis may require examinations in every 4 to 6 months of intervals, to observe if there are any changes in the curvature of the spine.

What are the treatments available for kyphoscoliosis?

The treatments of kyphoscoliosis mainly depend on the following factors:

  • The maturity level of the skeleton of the patient
  • The intensity of spinal curvature.

A small degree of spine curvature in a patient, who is still in the growing phase, does not require treatment; but the young Child with a significant curve usually continues to worsen, so it needs a proper treatment. There are three treatment options available for the scoliosis patients, such as;

  • Observation
  • Braces
  • Surgery 
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  1. Observation:

After your child is diagnosed with scoliosis, the doctor will keep the child in the observation period. He/she will check the curve on a regular basis, after every 4-5 months, to check if there is any change of the spinal curve. Depending on the rate of changes, your doctor will decide the next step of the treatment.

  1. Braces:

If the child is in a growing phase and having moderate scoliosis, your physician may suggest using a brace. Using a brace will not reverse the condition, but it will help stop the progression of the spinal curve. Usually, the braces are used day and night. The result of using a brace depends on the number of hours the patients wear it. The parents should always take care in following the instructions given by the doctor while using the braces because there is few restrictions on wearing a brace.

Taylor’s Brace

  1. Surgery:

Scoliosis progresses gradually with age. So, depending on the severity, the doctor may suggest for the surgery to decrease the curve of the spine and also prevent the further progression. The most common surgery performed for the scoliosis is spinal fusion. The surgery is usually done after the child’s bone stops growing. If kyphoscoliosis is progressing rapidly at the early age, surgeons can install a bar in between the spine bones to adjust the length as the child grows. Complications of spinal surgery can include bleeding, infection, and pain and nerve injuries. In rare cases, the bone does not heal. In that case, further, surgery is required.

Physiotherapy management for kyphoscoliosis:

Physiotherapy can be done where the spinal curvature of kyphoscoliosis is mild, i.e. if it is less than 50 degrees of kyphosis and if it is less than 30 degrees of scoliosis with the underlying cause of bad posture. In such cases, physiotherapy is beneficial and is the first line of treatment for Kyphoscoliosis. The aim of physiotherapy is strengthening the spinal muscles to correct the abnormal curvature of the spine as much as possible and also to prevent further spinal complications.

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