Kyphosis in a Turner syndrome population

Objective. The purpose of this study was to determine the prevalence of kyphosis in a Turner syndrome (TS) population. Methods. Standing lateral thoracic spine and standing anterior-posterior (A-P) scoliosis radiographs were obtained on all girls with TS between the ages of 5 and 18 years seen in a TS clinic between July 2000 and March 2001. Medical histories were reviewed, and a pediatric orthopedic surgeon evaluated the radiographs of each patient (N=25). Excessive kyphosis was defined as an A-P curvature >40degrees, vertebral wedging as any A-P deformity >5degrees at an individual vertebral body, and scoliosis as a lateral curvature >10degrees. Results. Fifteen (60%) of 25 patients were found to have abnormal radiographic findings: 10 (40%) of 25 with excessive kyphosis, 10 (40%) of 25 with vertebral wedging, and 5 (20%) of 25 with scoliosis. Forty-eight percent of the girls had both excessive kyphosis and/or vertebral body wedging. Two girls had kyphosis greater than or equal to55degrees, and 5 had scoliosis greater than or equal to25degrees. Girls with excessive kyphosis and/or vertebral body wedging were older (13.6+/-3.9 years vs 10.6+/-2.8 years). Conclusions. The prevalence of excessive kyphosis and vertebral body wedging seems to be increased in girls with TS and corresponds with advancing age. Routine radiologic surveillance may facilitate detection of developing deformities so that treatment with a brace can be considered to prevent or slow the process.