Spine problems Symptoms & Causes

At Boston Children’s Hospital, our team pioneers innovative spine treatments. And because our research informs our treatment, we’re known for our science-driven approach. We’re home to the world’s most extensive pediatric hospital research enterprise, and we partner with elite health care and biotech organizations around the globe. But as specialists in family-centered care, our physicians never forget that your child is precious, and not just a patient.

In dealing with your child’s spine problems, you may want to know the basics about how the spine works.

What are normal and abnormal spine curves?

Kyphosis and Lordosis compared to a normal spine

The normal spine is strong and mobile. While it varies in size and shape from person to person, the healthy spine has natural front-to-back curves that enable us to walk, balance, sit, stand and twist—all of which are complex interactive movements. When these natural front-to-back curves become too large, they can present a potential problem:

•   kyphosis (thoracic hyper-kyphosis, “round back”):
    When the backward curve in the thoracic spine is too great.

•   hypo-kyphosis: When there's not enough backward curve
    in the thoracic spine.

•   thoracic lordosis: When the natural outward curve in the
    thoracic spine is actually reversed, curving into the chest.

•   hyper-lordosis ("swayback"): When the inward curve in
    the lower back is too great.

Although the spine has natural curves from front to back, it shouldn’t curve sideways very much. A side-to-side curve is called scoliosis, and may take the shape of an “S” (double curve) or a long “C” (single curve). The spine is also rotated or twisted, pulling the ribs along with it to form a multidimensional curve.

When do normal spine curves develop?

In utero:

During fetal development, the primary curves develop (thoracic and sacral).

As babies: 

All infants start life with a C-shaped spine. Their secondary curves (cervical and lumbar) develop as they become able to:  

•   lift the head (cervical)
•   sit up (cervical)
•   crawl, stand and walk (lumbar)

As children: 

As children grow, their natural spinal curves continue to develop into a normal spine.

Spinal conditions we treat

Spinal conditions that we treat in infants and children include:

•   scoliosis
•   idiopathic scoliosis
•   neuromuscular scoliosis
•   congenital scoliosis and other vertebral anomalies
•   early-onset scoliosis
•   kyphosis
•   spina bifida
•   spinal deformities associated with bone dysplasias, metabolic bone disease and connective tissue disorders
•   spondylolysis
•   spondylolisthesis

Causes of spinal problems

Spinal problems can be:

•   congenital (present at birth)
•   neuromuscular (associated with a neuromuscular condition such as cerebral palsy or spina bifida)
•   idiopathic (definite cause unknown)
•   the result of bone dysplasias (genetically abnormal bone growth)
•   related to metabolic conditions (internal body chemistry)
•   related to connective tissue disorders
•   related to differences in leg lengths
•   related to spinal cord injury with paralysis
•   related to infection
•   related to tumors

Long-term outlook of spinal problems

The long-term outlook depends greatly on the nature and severity of the spinal condition, as well as the nature and severity of any underlying (neuromuscular or other) conditions. Most spinal problems are compatible over time with full normal function, normal appearance and good general health.