Orthopaedic conditions A-Z

The spine has an 'S' shape curve to it, when you look at it from the side.

This S shape helps a healthy spine withstand all kinds of stresses.

The small of the back (the lower back) curves into the body in a hollow – this is called lordosis.

The part of the back that sticks out (most noticeably the shoulders) is called kyphosis.

If you have lordosis, then you have an excessive inward curve of the lower back. If you have kyphosis, then you have an excessive outward curve of the upper back.

Kyphoscoliosis is scoliosis (curvature of the spine) with additional kyphosis.

This is a condition affecting the normal formation and growth of the vertebrae in the thoracic spine (the area of the spine around the chest).

It can cause kyphosis (where the spine curves outwards in the upper back). It can also cause a lordotic curve (where the lower back curves inwards) as the lower back tries to compensate for the kyphotic curve above.

It's more common in boys than girls, and generally occurs in adolescence.

Scoliosis (from Greek: skolíōsis, meaning 'crooked') is a lateral (side to side) curvature of the spine. It can occur at any time during a child's growth.

With growth, the spine rotates. The ribs are attached to the vertebrae and therefore rotation results in the formation of a rib hump.

The spine can curve towards either side of the body:

• thoracic scoliosis – a curve in the chest area
• lumbar scoliosis – a curve in the lower part of the back
• thoracolumbar scoliosis – a curve between the chest and lower part of the back.

Your spine may also develop another curve which is known as a 'compensatory curve'. This is your body's attempt to keep you as straight as possible.

The spine can even curve twice – a curve in the thoracic and lumbar spine is known as a double major curve.

What causes scoliosis?

Scoliosis usually develops in the early teenage years (9-15 years). It can develop quickly or slowly, depending on the cause.

There are four main types of scoliosis in children and young people:

• idiopathic – where the cause is unknown. This accounts for most spinal curvatures and is more common in girls than boys
• syndromic – where the curvature is part of a recognised disease pattern
• neuromuscular – where the cause is related to a neuromuscular condition which affects the nerves and muscles
• congenital – where the spine doesn't form properly when the baby is in the womb.

Symptoms of scoliosis

The main symptom of scoliosis is a change in body shape. Some people feel self-conscious due to this change, and it can make them feel self-conscious.

The spine is stable, but curved, although scoliosis can cause back ache during a growth spurt due to structural change.

Treatments

The aim of treatment is to stop the curve progressing. The choice of treatment depends on your age and severity of the curve:

• a minor curve may need no treatment, only monitoring
• a moderate curve may need the use of spinal brace to keep the spine straight. These are light and thin and worn under your clothes. More information about braces is in our patient information leaflets
• a severe curve may require spinal surgery. The aim of surgery is that you go on to live a full and normal life, although certain activities will be restricted for a period of time after surgery. Find out more about having spinal surgery.

The spine is the strong and flexible central support that holds your head and neck upright, yet allows your neck and back to bend and twist.

It extends down from the skull to the pelvis and is made up of 33 bones called vertebrae.

The vertebrae are stacked on top of each other and form into five groups:

• cervical spine
• thoracic spine
• lumbar spine
• sacrum
• coccyx