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Spinal Problems

What Spinal Problems can Occur in Childhood Cancer Survivors?

Treatment for childhood cancer can sometimes result in abnormal curvatures of the spine.

The spine is the group of bones held together with muscles and ligaments that are stacked in a straight line down the middle of the back.

Two distinct spine conditions that can result from childhood cancer treatment are called scoliosis and kyphosis.

Scoliosis

Scoliosis can occur in many young people, especially teenagers. Most often the cause is unknown. But certain cancer treatments can increase the risk of developing the condition.

It occurs when the spine rotates sideways. Normally, the spine appears as a straight line when viewed from the back. With scoliosis, the spine curves like the letter "S" or "C." Signs include:

  • Uneven shoulder blades
  • Uneven hips
  • Uneven waist
  • Leaning of the back to one side
  • Head not centered above pelvis
  • One leg longer than the other
Graphic showing a normal spine compared to a spine with scoliosis

Kyphosis

Kyphosis is an abnormal rounding of the upper part of the back with an appearance of slouching or a hump on the back. Symptoms include:

  • Poor posture
  • Back pain
  • Muscle fatigue
  • Stiffness in the back
Graphic showing a normal spine compared to a spine with kyphosis

Cancer Treatments That Cause Spinal Problems

Patients who have received certain types of radiation are at increased risk for uneven development of the muscles, bones, and soft tissues of the back. Therapies that can lead to problems include radiation to the chest, especially if:

  • Treatment area covered one half of the chest or abdomen
  • Surgery was also performed on the chest, abdomen, or spine

Radiation may also cause the spinal ligaments to stretch, increasing the natural curve of the spine. Radiation can also cause back muscles and ligaments to develop unevenly. Both problems can result in kyphosis.

Having a tumor in or near the spine can also cause spinal problems.

What Survivors Can Do

Scoliosis and kyphosis can be detected with physical examination.

Doctors may order X-rays of the spine. Scoliosis is diagnosed when there is at least a 10-degree lateral (side-to-side) curve on the X-ray. Kyphosis is confirmed when there is a 50-degree or higher curve on the X-ray.

Treatment for both conditions is usually handled in stages:

  • Observation. The curve should be closely monitored, particularly during puberty and other periods of rapid growth.
  • Brace. If the curve progresses, a plastic body brace should be worn underneath clothing to halt progression and attempt to correct abnormal curvature.
  • Surgery. In cases when realignment does not work, a physician may recommend surgery to fuse or stabilize spine bones. 


Reviewed: June 2018

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