Hesperian Health Guides

Chapter 20: Spinal Curve and Other Back Deformities

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HealthWiki > Disabled Village Children > Chapter 20: Spinal Curve and Other Back Deformities

a normal spine

The backbone, or ‘spine’, is a chain of bones called ‘vertebrae’ that connect the head to the hipbone. Separating each of the vertebrae is a small cushion called a ‘disk’. The backbone holds the body and head upright. It also encloses, in its hollow center, the ‘spinal cord’ or trunk line of nerves connecting the brain
to all parts of the body.

DVC Ch20 Page 161-4.png
Sideways curve
(scoliosis — S-shaped curve)
May result from unequal paralysis of back muscles or from a hip tilt due to one shorter leg. Sometimes the cause is not known.
DVC Ch20 Page 161-5.png
Rounded back
May result from weak back muscles or from poor posture (bent over position when standing or sitting).
DVC Ch20 Page 161-6.png
May result from weak stomach muscles,
from hip contractures, or from the way a child walks to make up for a weak leg or hip.
DVC Ch20 Page 161-7.png
Sharp bend or bump in spine (tuberculosis of the backbone)
Results from destruction of one or more vertebrae by tuberculosis infection.

Of these different problems, scoliosis or a sideways curve is the most common serious problem. Often, however, rounded and/or swayback are seen together with scoliosis.


With a non-fixed or ‘functional’ curve there is no deformity of the vertebrae. This usually happens when the body tries to stand straight even though the hips tilt or there is other unevenness not in the spine.

DVC Ch20 Page 161-8.png
For example, a child with a shorter leg from polio will stand with his hips tilted. For him to stand straight, the spine has to curve.
DVC Ch20 Page 161-9.png
A non-fixed curve can usually be straightened by putting blocks under the foot or by holding the child up under the arms.
DVC Ch20 Page 161-10.png

Fixed or ‘structural’ curves are deformities in the bones of the back themselves.

DVC Ch20 Page 161-11.png
A fixed curve cannot be straightened by positioning or holding up the child.

Note: In some cases, with time a non-fixed curve may gradually become fixed.

This page was updated:21 Nov 2019