Most frequent pathologies in children part 2

Centro de la columna Vertebral: April 1, 2016/b>

Patologias de columna más frecuentes en niños 2da parte.

Most frequent pathologies in children part 2

In general, these types of deformities are progressive and cause congenital scoliosis at young age, with a tendency to reach many degrees of deformity, so they usually need early surgical treatment.

    • Scoliosis: It is an abnormal lateral curvature of the spine associated with rotation of the vertebrae; it is the most common cause of spinal deformity in children.

    • Kyphosis : It is the abnormal increase of the convexivity of the thoracic portion of the spine.

    • Hyperciphosis : An excess in the curvature of kyphosis.

    • Lordosis : An excessive and abnormal concavity of the lumbar curve of the spine.

    • Hyperlordosis : When the curvature of lordosis is pronounced too much.

Idiopathic scoliosis

It is an alteration of the alignment of the spine with lateral deviation of the rachis, but with a torsional component that deforms the spine in the three planes of space.

Scoliosisis a relatively frequent finding in the pediatrician's consultations and in most cases it is idiopathic in the case of adolescents; in other words, without known cause and that appears at the moment of puberty development, during which an acceleration of the growth of the rachis takes place. There is also infantile and juvenile scoliosis, but they represent a minority of cases.

The prevalence of scoliosis in the population is around 1%; most are under 20º andover 90% of them are idiopathic scoliosis..

It is therefore very important to screen for this pathology, since it can be detected initially with physical examination and its treatment varies greatly depending on the degree of deformity that is reached.

The key test for its detection during physical exploration is the inclination test or Adams' test, in which the midsection is flexed and manifests the appearance of the costal hump or the lumbar prominence that accompanies scoliosis.


Kyphosis is an alteration of the sagittal plane of the spine with an increase in dorsal physiological kyphosis, which ranges from 20 to 40º between the upper T5 plate and the lower T12 plate.

The most frequent pathology related to kyphosis is postural kyphosis, typically in pre-adolescent and adolescent patients, which can sometimes be accompanied by pain, but said pain is actively corrected with spinal hyperextension.

Patients need exercises to strengthen the dorsal and abdominal muscles, along with postural self-control, although periodic reviews are necessary due to the frequency of treatment abandonment.

Painful spine in children

Unlike in adults, where lumbar or cervical pain is very frequent, often of mechanical or even psychological origin, in children back pain is rare, and when it persists for more than 2 weeks, an organic origin must be suspected.

Of 100 children with back pain lasting more than 2 months, 33 had spondylolysis, spondylolisthesis or hidden fractures, 33 had kyphosis or scoliosis, 18 had an infection or a tumor, and in only 16 no triggering cause was found.

Therefore, when faced with a picture of lumbar, dorsal or cervical pain in a child, it is necessary to be meticulous with the clinical history and the physical examination, and evaluate the radiographic study from the outset, in which a high level of suspicion must be maintained in order to detect possible alterations

In the case of a moderate pain, lasting a short while and without significant findings in the history and exploration, with normal radiography, the prudent thing is to carry out a symptomatic treatment with analgesics or anti-inflammatory medication and eventually include rehabilitation treatment, and in the case of pain persisting more than 1 or 2 months, it is recommendable to continue with diagnostic tests such as gammagraphy and magnetic resonance. The treatment will depend on the cause of the deviation.

It is very important to prevent these injuries during childhood and youth, through correct postures, gymnastic exercises (such as knowing the correct movement of the spine, postural activity), not carrying heavy backpacks and also doing some exercises established in swimming, which is a very good sport for the rehabilitation of bad spinal posture.

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“The information contained in this blog is of an informative nature; it seeks to promote good health habits in the population and by no means replaces medical consultation. Content reviewed and corrected by Dr. Armando Acevedo Mendez, orthopedics and traumatology specialist. Professional license: 602691.”

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