Spinal Curvature in Hypochondroplasia: What To Know

If your child has hypochondroplasia, you may notice their posture changing as they grow. A more pronounced curve in their lower back can make it look like they’re standing with their belly pushed forward.

But is this something to be alarmed about? Will they need surgery?

We talked with pediatric orthopaedic surgeon Kevin Serdahely, MD, to find out.

“Typically, while spine curvature may be a possible sign of hypochondroplasia, it often won’t be the first sign, and the curvature itself generally won’t need any serious intervention,” Dr. Serdahely says. “It’s rare for children with hypochondroplasia to end up needing spine surgery, for example.”

Why does spinal curvature happen in hypochondroplasia?

Hypochondroplasia is a genetic condition that affects bone growth. As your child grows, it can affect the shape and alignment of their spine.

The most common spinal change is an exaggerated inward curve in their lower back, known as lumbar lordosis or swayback.

“In young kids, this lordosis usually presents as a very prominent abdomen,” Dr. Serdahely explains. “They appear to walk belly forward.”

What do parents usually notice first?

Because hypochondroplasia is often diagnosed later than achondroplasia, a related skeletal dysplasia, families may not notice posture changes until toddlerhood or early school years.

But Dr. Serdahely says the spinal changes themselves aren’t typically painful and often don’t interfere with daily activities.

“It’s more of a clinical finding,” he notes. “In other words, providers may notice the curve during an exam, but it usually doesn’t cause symptoms or interfere with everyday activities.”

When should families be concerned?

While smaller spinal changes don’t require treatment, healthcare providers still monitor children over time to make sure other symptoms aren’t developing. You should talk with your child’s care team if you notice:

• Back or leg pain
• Changes in walking or mobility
• Reduced endurance during play or physical activity
• Any other symptoms that worsen over time

For example, if your child develops pain, weakness or has trouble staying active, their provider may order imaging studies to look for spinal narrowing (stenosis). This narrowing can put pressure on nerves, but it is more common in achondroplasia.

What about physical therapy or bracing for spinal curvature?

If your child’s spinal curvature causes discomfort, physical therapy may help improve flexibility and address muscle tightness.

“If I had a child with hypochondroplasia who had some of that exaggerated curvature and had pain, that would be a time to get them involved with a physical therapist,” Dr. Serdahely shares.

Surgery is uncommon in hypochondroplasia-related spinal conditions. That’s one significant difference between hypochondroplasia and achondroplasia. Achondroplasia more often causes significant spinal narrowing and may require surgical treatment.

Can my child still be active?

For most children, the answer is yes.

While spinal curvature is common in children with hypochondroplasia, if it happens, it usually doesn’t require treatment and rarely limits daily activities. Regular check-ups can help monitor any changes, but most children can continue to play, participate in sports and stay active.

“Certainly, they would be allowed to do anything and everything they want to do,” Dr. Serdahely encourages.