Kyphosis or hunching over is normal in the thoracic spine. If you look at your child from the
side, you will notice that there is a curve in the upper back where they are "hunched over", and
a curve in the lower spine ("sway back"). Some kyphosis is normal.
When the doctor measures it on an x-ray, the normal range for kyphosis is quite broad, between 20-50 degrees. However, when kyphosis is greater than 50 degrees, it becomes
easy to see and is considered abnormal. Most parents will attribute this to "poor posture", but become concerned that despite their persistent reminders, their child will not stand up
straight.
There are two common forms of kyphosis encountered in the teenage population: Scheueremann's kyphosis and Postural Roundback. Scheueremann's kyphosis is most common in teenage boys. It is characterized by a short, sharp kyphosis in the middle part of
the upper spine, and may be associated with aching back pain. The kyphosis tends to be
rigid on clinical examination. There are x-ray criteria that establish a diagnosis of Scheueremann's kyphosis that can be seen on the x-ray. A mild degree of scoliosis is
common in adolescents with Scheueremann's kyphosis.
Postural Roundback is noted by a smooth, flexible kyphosis that is not typically associated
with pain. The curve is easily corrected by asking the child to stand up straight. Radiographically, the criteria for the diagnosis of postural roundback are kyphosis greater
than 50 degrees, but without the other x-ray findings seen with Scheueremann's kyphosis. These curves tend to be mild in severity and extend over a longer number of vertebral segments when compared to Scheueremann's kyphosis.