Spinal Deformity – Scoliosis and Kyphosis

Spinal deformity refers to abnormal curvature or alignment of the spine that may affect balance, posture and neurological function. Two of the most common forms of spinal deformity are scoliosis and kyphosis. These conditions can present in childhood, adolescence or adulthood and may progress over time depending on the underlying cause.

Scoliosis

Scoliosis is an abnormal curvature of the spine that occurs in the coronal plane, resulting in a side-to-side curvature. It can affect individuals of any age. Symptoms and severity vary depending on the age of onset and the degree of curvature.

In infants and young children, scoliosis may be associated with cosmetic concerns, sitting imbalance, breathing difficulties or delayed development. In adolescents, features such as rib prominence, pelvic asymmetry or uneven shoulder height are commonly observed. In adults, scoliosis may present with persistent back pain, leg pain, sciatica, weakness, numbness or difficulty walking, often prompting consideration of surgical correction.

Infantile Scoliosis

Infantile scoliosis occurs in children under three years of age and is frequently associated with congenital or neurodevelopmental conditions such as cerebral palsy, tethered spinal cord or myelomeningocele. While surgery may be required in selected cases, non-operative techniques are often used initially to allow continued spinal growth before definitive fusion is considered.

Juvenile Scoliosis

Juvenile scoliosis affects children between three and ten years of age. These spinal curves have a higher risk of progression as the child grows. Bracing is commonly used as first-line treatment until the child reaches an appropriate age and size for surgical correction. In more severe or progressive cases, surgery may be required before adolescence.

Adolescent Idiopathic Scoliosis

Adolescent idiopathic scoliosis is the most common form of scoliosis and occurs in patients aged between ten and seventeen years. There is no identifiable cause, and the severity and progression vary widely. Treatment decisions are guided by the size of the curve and evidence of progression.

This condition is usually not painful and is rarely associated with neurological symptoms such as leg weakness or numbness. Most curves occur in the thoracic spine, between the neck and lower back. Scoliosis that appears stable during adolescence may worsen later in life due to degenerative changes, leading to what is sometimes referred to as neglected or decompensated scoliosis in adulthood.

Adult Degenerative Scoliosis

Adult degenerative scoliosis develops later in life as a result of age-related degeneration within the lumbar spine. These patients typically did not have scoliosis in childhood. The condition often progresses over time and is commonly associated with back pain, leg pain and nerve compression due to spinal stenosis.

Kyphosis

Kyphosis refers to an excessive forward curvature of the spine that alters normal spinal balance. When the spine is unable to maintain an upright posture, patients may develop a forward-flexed walking position and find it difficult to stand fully upright.

Kyphosis can result in progressive deformity, pain and, in some cases, neurological impairment. It may also occur in combination with scoliosis, a condition known as kyphoscoliosis, which can further affect balance and spinal function.

Assessment by a Spine Surgeon in Nottingham is important to determine the type and severity of spinal deformity and to guide appropriate non-surgical or surgical management.