Infantile thoracolumbar kyphosis secondary to lumbar hypoplasia.
BACKGROUND
There is a normal transition from the kyphotic alignment that is present in the spine of the newborn to the normal sagittal contours that are present in the adult spine. Although abnormal kyphosis at the thoracolumbar junction in infants is rare, it can result from congenital anomalies and bone dysplasias. We report the cases of seven otherwise normal infants who had thoracolumbar kyphosis due to lumbar hypoplasia, with total spontaneous resolution over time.


METHODS
The medical records of seven patients who met the inclusion criteria were reviewed. Clinical data and radiographs were analyzed to rule out the presence of congenital anomalies or bone dysplasias. Progression of kyphosis was measured on serial radiographs made with the patient sitting and standing.


RESULTS
All patients were managed conservatively with observation alone. No patient had a neurologic deficit. The average age at the time of the initial diagnosis was 5.3 months, and the average duration of follow-up was 5.7 years. Three cases of kyphosis were secondary to L1 hypoplasia, and four were secondary to L2 hypoplasia. The average initial kyphosis was 34.2 degrees, which progressed to 0.4 degrees of lordosis at the time of the latest follow-up.


CONCLUSIONS
Thoracolumbar kyphosis in normal infants secondary to lumbar hypoplasia may resolve spontaneously. After congenital anomalies and bone dysplasias are ruled out, a period of observation is advised.
Campos
Mauricio A
MA
University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA.
Fernandes
Pedro
P
Dolan
Lori A
LA
Weinstein
Stuart L
SL
D002648:Child; D003937:Diagnosis, Differential; D018450:Disease Progression; D005260:Female; D006801:Humans; D007223:Infant; D007738:Kyphosis / Q000175:diagnosis* / Q000628:therapy; D008159:Lumbar Vertebrae / Q000002:abnormalities*; D008297:Male; D013904:Thoracic Vertebrae / Q000002:abnormalities*