The progression of untreated lumbar kyphosis and the compensatory thoracic lordosis in myelomeningocele

Radiographs of 37 patients with untreated lumbar kyphosis without congenital vertebral anomalies associated with myelomeningocele were analyzed. With an average interval between radiographs of 6.2 years, the kyphosis was noted to increase at a mean rate of 4.3 degrees per year without correlation to its initial magnitude. The compensatory lordosis was more variable and progressed at a mean of 2.5 degrees per year. Children under the age of 2 years were more likely to increase the Cobb angle and the height of their kyphosis. There was an inverse relationship between the height of the kyphus and the lumbar spine height and the resultant growth of each. A modified kyphotic index less than 4 correlated with an increase in the curve and height of the kyphosis and the subsequent desire for surgery. Wide variability in radiographic parameters make predictions for an individual patient difficult.