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  • Hypokyphosis

    Hello,
    My daughter has scoliosis and hypokyphosis. Her doctor says that her hypokyphosis is "remarkable" - I am thinking that he means that it is pretty bad. She has been wearing a brace for over 4 years now. She started wearing a Boston-type brace and is now wears the LA brace. Her curves are now at T-33 and L-23 out-of-brace. She is also a ballet dancer; she has been dancing for 10 years now. I'm wondering if anyone can explain the hypokyphosis and how it relates to the scoliosis? Does it make the scoliosis worse? Does ballet make the scoliosis worse? Does ballet make the hypokyphosis worse? My daughter is 15 and has about 1-1/2 years left to grow.

    Thanks!!

  • #2
    Originally posted by scolio1964 View Post
    I'm wondering if anyone can explain the hypokyphosis and how it relates to the scoliosis? Does it make the scoliosis worse?
    As Gayle (LeahDragonfly) once explained to me, braces achieve a correction, in part by hypokyphosing the back. But I think it is also the case that hypokyphosis can go along naturally with scoliosis. So in your daughter's case, it could be natural with the scoliosis, or due to the brace, or both.

    Does ballet make the scoliosis worse?
    There is no high quality data on that to my knowledge. Rather, people who are successful at ballet might have a higher preponderance of scoliosis. Just like rhythmic gymnastics favors hypermobility which sometimes goes along with scoliosis. But it's quite common to see folks mix cause and effect on this and mistakenly think these activities cause scoliosis.

    Does ballet make the hypokyphosis worse?
    There is no high quality data on that to my knowledge.

    My daughter is 15 and has about 1-1/2 years left to grow.
    That seems very unusual. How did the surgeon determine she will grow until she is ~16.5 years old?
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

    Comment


    • #3
      Originally posted by Pooka1 View Post
      That seems very unusual. How did the surgeon determine she will grow until she is ~16.5 years old?
      I was about to say the same thing. While every child is different, I would say girls are 'generally' done with most, if not all, of their growth by about age 14. That was the case for my daughter. I even know some girls who were told by age 12 1/2 or 13 that they had accomplished most of their growth. Of course, your daughter could be the exception but I, like Pooka, was surprised to hear they expect her to grow until she is 16 1/2.

      Just out of curiosity, what were your daughter's curves 4 years ago before she was braced?
      mariaf305@yahoo.com
      Mom to David, age 17, braced June 2000 to March 2004
      Vertebral Body Stapling 3/10/04 for 40 degree curve (currently mid 20's)

      https://www.facebook.com/groups/ScoliosisTethering/

      http://pediatricspinefoundation.org/

      Comment


      • #4
        Thanks for your responses. My daughter just started menstruating about 10 months ago, right before she turned 15. We go to the doctor every 4 months for x-rays and she has grown each time. Not a lot, only about 1/8-1/4 of an inch, but he won't x-ray her hand until she doesn't grow between visits. When she first started wearing her brace, I believe her top curve was about 28 degrees and there wasn't much of a bottom curve at all. Her curve progressed to about 40 and then we changed braces. She's doing better now, but of course I still worry.

        Comment


        • #5
          Originally posted by scolio1964 View Post
          Thanks for your responses. My daughter just started menstruating about 10 months ago, right before she turned 15. We go to the doctor every 4 months for x-rays and she has grown each time. Not a lot, only about 1/8-1/4 of an inch, but he won't x-ray her hand until she doesn't grow between visits. When she first started wearing her brace, I believe her top curve was about 28 degrees and there wasn't much of a bottom curve at all. Her curve progressed to about 40 and then we changed braces. She's doing better now, but of course I still worry.
          She got up to 40* but is now 33* out of brace. Since that doesn't happen in AIS, I looked back in the threads and sure enough, you found your daughter's curve very early making this a JIS case. Case solved.

          Maybe she can get even lower permanently if she does have growth left.
          Sharon, mother of identical twin girls with scoliosis

          No island of sanity.

          Question: What do you call alternative medicine that works?
          Answer: Medicine


          "We are all African."

          Comment


          • #6
            Originally posted by Pooka1 View Post
            She got up to 40* but is now 33* out of brace. Since that doesn't happen in AIS, I looked back in the threads and sure enough, you found your daughter's curve very early making this a JIS case. Case solved.

            Maybe she can get even lower permanently if she does have growth left.
            Yes, I found it when she was 7, although she didn't need the brace until she was about 11. I had surgery when I was 15, and there are several people on my mom's side who have it, so I checked her all the time when she was little. I wanted to be able to keep her from having surgery. I don't know if that will be the case, but I hope so. What do you mean by "case solved"?

            Comment


            • #7
              Braces don't claim to permanently reduce curves. They only claim to try to halt progression. But your daughter's curve appears to have been reduced. That doesn't happen in AIS which I assumed you were dealing with. So this was a mystery that needed "solving." The solution was you are dealing with JIS not AIS.

              Another "solution" would be if you removed the brace just prior to the radiograph and didn't wait 24-48 hours. But that would be a false solution.
              Sharon, mother of identical twin girls with scoliosis

              No island of sanity.

              Question: What do you call alternative medicine that works?
              Answer: Medicine


              "We are all African."

              Comment


              • #8
                Originally posted by Pooka1 View Post
                Braces don't claim to permanently reduce curves. They only claim to try to halt progression. But your daughter's curve appears to have been reduced. That doesn't happen in AIS which I assumed you were dealing with. So this was a mystery that needed "solving." The solution was you are dealing with JIS not AIS.

                Another "solution" would be if you removed the brace just prior to the radiograph and didn't wait 24-48 hours. But that would be a false solution.
                She always has her brace off at least 24 hours before the x-ray. I didn't realize that a brace can improve curves in JIS, not in AIS. I do believe that she is still growing, even though she's almost 16, so I am hopeful that her curves will improve. Even when we're told that she's not growing anymore, she still will continue to wear her brace. We've heard too many stories of people whose curves progressed after they thought they were finished growing.

                Comment


                • #9
                  Originally posted by scolio1964 View Post
                  She always has her brace off at least 24 hours before the x-ray. I didn't realize that a brace can improve curves in JIS, not in AIS.
                  There are several testimonials where braces reduced JIS curves on this forum. In contrast, there is not a single one for a brace reducing an AIS curve.

                  I do believe that she is still growing, even though she's almost 16, so I am hopeful that her curves will improve. Even when we're told that she's not growing anymore, she still will continue to wear her brace. We've heard too many stories of people whose curves progressed after they thought they were finished growing.
                  How long after she finishes growing will she wear the brace do you think?
                  Sharon, mother of identical twin girls with scoliosis

                  No island of sanity.

                  Question: What do you call alternative medicine that works?
                  Answer: Medicine


                  "We are all African."

                  Comment


                  • #10
                    Originally posted by scolio1964 View Post
                    Hello,
                    My daughter has scoliosis and hypokyphosis. Her doctor says that her hypokyphosis is "remarkable" - I am thinking that he means that it is pretty bad. She has been wearing a brace for over 4 years now. She started wearing a Boston-type brace and is now wears the LA brace. Her curves are now at T-33 and L-23 out-of-brace. She is also a ballet dancer; she has been dancing for 10 years now. I'm wondering if anyone can explain the hypokyphosis and how it relates to the scoliosis? Does it make the scoliosis worse? Does ballet make the scoliosis worse? Does ballet make the hypokyphosis worse? My daughter is 15 and has about 1-1/2 years left to grow.

                    Thanks!!
                    Hi
                    I have an 11 yr old with scoliosis and hypokyphosis. As Pooka (Sharon) has said, the HK can be brace induced (common) or hand-in-hand with the scoliosis. My daughter is hand-in-hand.
                    The HK is (put simply) a flattening or decrease of the natural outward curve of the upper (thoracic) spine. In some kids, the scapula touch together in the middle of the back.

                    My daughter STARTED ballet about 3 - 4 months ago. In my opinion, ballet CAN make scoliosis worse (e.g., loading the curves leaping), but can also assist in correction (spinal flexibility and strength). (There are a few ballerinas with curves = or > than your daughter's; Wendy Whelan, for example, exercises to specifically correct her scoliosis after her ballet.) I've heard anecdotal stuff about ballet increasing lumbar lordosis.

                    Interesting that you've been told your daughter will grow for a year or so still. Coincidentally, last week, our spine surgeon remarked that my daughter is probably around 1 - 1.5 years BEHIND typical growth for a kid her age. Is your daughter low-BMI (is she slightly built)? Appetite? Last summer, during a Schroth clinic, we met an almost 17 year old girl and her parents; late menarche (15.5), grew INCHES thereafter, and only then did her curves take off (T55, L27).

                    Although we didn't diagnose our kid until 10 yrs old, she is definitely JIS--around 6 yrs, we had a surgeon friend check her back after she repeatedly complained of "discomfort". All seemed perfect. She grew a lot just before her 10th birthday and then cat popped out of the bag.

                    If my kid gets to the same age as your kid, with curves at the same level as your kid's, I'd sleep easier, but, like you, be vigilant with corrective exercise and possibly bracing. (I'm on the fence re. bracing: in my experience, they can do a lot of damage or a lot of good.)

                    Keep in touch.
                    Regards
                    Tom
                    07/11: (10yrs) T40, L39, pelvic tilt, rotation T15 & L11
                    11/11: Chiari 1 & syrinx, T35, L27, pelvis 0
                    05/12: (11yrs) stopped brace, assessed T&L 25 - 30...>14lbs , >8 cm
                    12/12: < 25 LC & TC, >14 cms, >20 lbs, neuro symptoms abated, but are there
                    05/13: (12yrs) <25, >22cms height, puberty a year ago

                    Avoid 'faith' in 'experts'. “In consequence of this error many persons pass for normal, and indeed for highly valuable members of society, who are incurably mad...”

                    Comment


                    • #11
                      Originally posted by Pooka1 View Post
                      There are several testimonials where braces reduced JIS curves on this forum. In contrast, there is not a single one for a brace reducing an AIS curve.



                      How long after she finishes growing will she wear the brace do you think?
                      Well, then I'm glad that she is JIS and not AIS!! I think it will depend on when the doctors tell me she's finished growing. I think if she just sleeps in the brace, that might be okay, but I don't know. She's been wearing a brace for so long now, that she's used to sleeping in it. She finds it weird to sleep without it on the one night every four months she has her x-ray. I read somewhere that some girls can still grow until they are 21. I don't know if she will wear until then, if she has any say-so, but if I have any say-so, she'll still be sleeping in it.

                      Comment


                      • #12
                        Originally posted by TAMZTOM View Post
                        Hi
                        I have an 11 yr old with scoliosis and hypokyphosis. As Pooka (Sharon) has said, the HK can be brace induced (common) or hand-in-hand with the scoliosis. My daughter is hand-in-hand.
                        The HK is (put simply) a flattening or decrease of the natural outward curve of the upper (thoracic) spine. In some kids, the scapula touch together in the middle of the back.

                        My daughter STARTED ballet about 3 - 4 months ago. In my opinion, ballet CAN make scoliosis worse (e.g., loading the curves leaping), but can also assist in correction (spinal flexibility and strength). (There are a few ballerinas with curves = or > than your daughter's; Wendy Whelan, for example, exercises to specifically correct her scoliosis after her ballet.) I've heard anecdotal stuff about ballet increasing lumbar lordosis.

                        Interesting that you've been told your daughter will grow for a year or so still. Coincidentally, last week, our spine surgeon remarked that my daughter is probably around 1 - 1.5 years BEHIND typical growth for a kid her age. Is your daughter low-BMI (is she slightly built)? Appetite? Last summer, during a Schroth clinic, we met an almost 17 year old girl and her parents; late menarche (15.5), grew INCHES thereafter, and only then did her curves take off (T55, L27).

                        Although we didn't diagnose our kid until 10 yrs old, she is definitely JIS--around 6 yrs, we had a surgeon friend check her back after she repeatedly complained of "discomfort". All seemed perfect. She grew a lot just before her 10th birthday and then cat popped out of the bag.

                        If my kid gets to the same age as your kid, with curves at the same level as your kid's, I'd sleep easier, but, like you, be vigilant with corrective exercise and possibly bracing. (I'm on the fence re. bracing: in my experience, they can do a lot of damage or a lot of good.)

                        Keep in touch.
                        Regards
                        Tom
                        Hi Tom,
                        I will have to go back now and look at my daughter's first x-rays to see if she had hypokyphosis then. The first brace she wore, I've heard, can encourage the hypokyphosis. I didn't know that at the time. I sure wish I did.

                        I wonder about the ballet. I have been wondering about the flexibility, too. My daughter's flexibility in her back has decreased tremendously since she has worn her brace. I wonder if that is good because then her spine won't move around so much?? Or is it bad because it won't move around so much and that makes it harder to correct in her brace?? I find all of this very complicated. My daughter just loves ballet, though. That has been her motivation to wear her brace. She would like to dance professionally someday.

                        Yes, her BMI is extremely low. We were very worried for a long while because of the late-menarche, but her doctor assured me she was fine and right on track. She did grow 3 inches the year her curves progressed the most. Since those 3 inches, she's just grown about 1 inch, and that's been 1-1/2 years. I am really hoping that she does not grow much more, or if she does grow, that it will be slow growth.

                        I'm not sure about the brace either. I just knew that if her curves progressed to surgery level, like mine did, she wouldn't be able to dance professionally. So, I've just tried to do everything I can to try to prevent it. She has learned a little of the Schroth and we are going this summer for a 2-week course in Wisconsin.

                        Is your daughter currently wearing a brace? Do you know of any specific exercises that can help the hypokyphosis?

                        Comment


                        • #13
                          Originally posted by scolio1964 View Post
                          My daughter's flexibility in her back has decreased tremendously since she has worn her brace. I wonder if that is good because then her spine won't move around so much?? Or is it bad because it won't move around so much and that makes it harder to correct in her brace??
                          My understanding is that spinal flexibility is required to enable curve correction. If a kid was hyper-corrected in-brace (so had a sufficiently flexible spine to get to that level of IB correction), the spinal ligaments would also be corrected into that alignment; one could theorise that this inflexibility could benefit stability. (There is no medical unanimity on this one, frustratingly.)

                          My daughter just loves ballet, though. That has been her motivation to wear her brace. She would like to dance professionally someday.
                          Ditto.

                          Yes, her BMI is extremely low.
                          There is a low-BMI subset of scoliotic girls. Tamzin is definitely in that subset. Has you daughter had a MRI scan?

                          She has learned a little of the Schroth and we are going this summer for a 2-week course in Wisconsin.
                          We did a 4 week Schroth clinic in London in July 2011 and have been doing Schroth + other exercises since (torso rotation added recently, rowing, Roman Chair, some Pilates specifically for flexibility and strength without compromising the curves.

                          Is your daughter currently wearing a brace?
                          Tamzin wore a SpineCor brace from Dec until May (last week). At all FOUR fitting and adjustment appnts. (Dec, Jan, March, May), I queried the compression that was being exerted by the shoulder bands. Examined clinically by our spine surgeon, he estimated her curves at "25 - 30 degrees", corrected from circa. T41, L39 last June. The in-brace scan, however, showed the curves at 37 - 40 thoracic, 32 - 34 lumbar. In short, the bloody brace WAS compressing her spine. She hasn't worn it since. (I haven't decided whether the resume brace wearing: the SpineCor could be made to fit with different shoulder bands, but my suggestions fall outside the SpineCor rigid protocol and configuration script; we could get a Cheneau, but I simply have too many concerns despite the well-known benefits. Maybe I just think too much!)
                          PS: Tamzin has grown approx. 7 cm since last June, 3 cm since March.

                          Do you know of any specific exercises that can help the hypokyphosis?
                          We exercise CONSTANTLY to correct the hypokyphosis. PM (personal message) me and we'll talk.

                          Regards
                          Tom
                          07/11: (10yrs) T40, L39, pelvic tilt, rotation T15 & L11
                          11/11: Chiari 1 & syrinx, T35, L27, pelvis 0
                          05/12: (11yrs) stopped brace, assessed T&L 25 - 30...>14lbs , >8 cm
                          12/12: < 25 LC & TC, >14 cms, >20 lbs, neuro symptoms abated, but are there
                          05/13: (12yrs) <25, >22cms height, puberty a year ago

                          Avoid 'faith' in 'experts'. “In consequence of this error many persons pass for normal, and indeed for highly valuable members of society, who are incurably mad...”

                          Comment


                          • #14
                            Ballet and bracing

                            We're there, too! You said your daughter has hypokyphosis; mine does, too, but has only worn her brace for a few months. Ours is surely not brace induced at this early stage, and isn't for many, I venture; hypokyphosis seems to often go hand in hand with the scoliosis AND/OR ballet. (We are NOT stopping dance; the strength and flexibility benefits far outweigh my concerns.)
                            Glad to see you on the nsf. We are in a Cheneau brace (which I think is much like the LA Brace?) and I absolutely plan on seeing her more corrected after brace wear. Our doctor said that although he often recommends surgery for children at my daughter's curves degrees (43 last week,) at the last in-brace xray, upon seeing her in-brace correction, he said he definitely recommends that we continue with our conservative treatment plan of exercise + brace. He expects her to be 30-35 degrees after brace weaning (He is not a quack 'guaranteeing' this, just based on his experience. Her inbrace correction is currently 12 degrees.)
                            I'm trying for better, but will take that if possible. We live in Germany, and our doctor IS a surgeon and the head of the spine team at Heidelberg University Hospital. HE has seen enough post brace-wear to acknowledge real correction happens, and I believe it. We did have an MRI and ruled out neurological problems.
                            Emily, 43
                            approx 50 T, 36 T/L

                            Comment


                            • #15
                              Originally posted by scolio1964 View Post
                              I read somewhere that some girls can still grow until they are 21.
                              While there is always an exception to the rule, I would say it is extremely rare for a girl to grow to age 21.
                              mariaf305@yahoo.com
                              Mom to David, age 17, braced June 2000 to March 2004
                              Vertebral Body Stapling 3/10/04 for 40 degree curve (currently mid 20's)

                              https://www.facebook.com/groups/ScoliosisTethering/

                              http://pediatricspinefoundation.org/

                              Comment

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