Vice Chairman & Head - Ortho Spine, MIS & Robotic Spine Surgery, BLK-Max Super Speciality Hospital, New Delhi
Part 15 of 18 in Spinal Surgery: Advances in Techniques & Technology for Excellent Patient Outcomes
Scoliosis and Kyphosis in Children: Types and Warning Signs
August 5, 2026
Scoliosis is a sideways curve of the spine and kyphosis is a forward hump, and both can appear from birth or around puberty, with early warning signs including uneven shoulders, a tilted head, or a rib hump on one side of the back. Recognising these signs early is essential before considering spine surgery in India for a child.
The three types of scoliosis
Idiopathic scoliosis is the most common type, usually appearing around puberty, and is about seven times more common in girls. Congenital scoliosis is caused by a birth defect called a hemivertebra, a half-formed vertebra that causes the spine to tilt progressively as the child grows. Neuromuscular scoliosis occurs in children with conditions such as cerebral palsy or spinal muscular atrophy, who lack the muscle control to maintain sitting balance, producing a C-shaped spinal curve.
Warning signs to look for
Parents and doctors should check whether the shoulders are level, whether the head is centred above the pelvis, and whether one hip appears more prominent or the child limps. A rib hump on one side of the back suggests thoracic scoliosis, and an uneven waist suggests a loss of trunk balance. Changes in the skin over the spine, such as dimples, hairy patches or colour changes, can point to spina bifida or a related syndromic condition, and any overall leaning of the body to one side is also a warning sign.
Why early detection matters
Children with any of these signs should be assessed early, since scoliosis and kyphosis are far easier to treat, and far less invasive to correct, when caught before the curve becomes severe. Dr. Puneet Girdhar at BLK-Max Super Speciality Hospital sees children referred for scoliosis screening from across Africa, and early referral makes a significant difference to the complexity of any eventual spine surgery in India.
← Robotic Spine Surgery for Complex and Revision Cases | Series index | Scoliosis Treatment: When Observation, Bracing or Surgery Is Needed →
This article is based on a Jivo Masterclass session conducted by Dr. Puneet Girdhar, Chairman, Max Institute of Robotics and Minimal Invasive Spine Surgery, BLK-Max Super Speciality Hospital, New Delhi. The article has been summarised with the assistance of an AI tool from the original masterclass recording. Watch the full Masterclass recording
This guide is based on a live Jivo Masterclass — Dr. Puneet Girdhar taught doctors across Africa on August 10, 2025.
FROM THE LIVE Q&A
Dr. Frank, referring physician, Ghana
I wanted to share how Paulina has been doing since her surgery with you — honestly speaking, I was really impressed by her recovery time. She's come back to Ghana and she's always praising your team, and now I have even more patients lining up who also want to come and have a consultation, and possibly the surgery, after hearing about her experience.
Dr. Puneet Girdhar
We feel privileged to be treating your patient, and I hope we have done justice to you, your practice and of course the patient. I think at the end of the day we all have one common goal — we want to see our patients happy. Otherwise you, me and Jivo would not be here on a Sunday evening, leaving our families aside, if we did not have this goal.
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Frequently Asked Questions
I'm also trying to go into orthopedic surgery myself, and I'm really happy learning more about it and seeing the advances in the surgery you're doing. Out of curiosity — how many of your own fellows go on to specialize in spine surgery after training under you?▼
I always joke about this with my orthopedic fellows. I've had an orthopedic training program for the last 13 or 14 years, and not even one of them has opted for spine surgery as a career — they're very happy doing a knee replacement, arthroscopy, or a fracture nail instead. Spine surgery has evolved so much that the moment they look into the scope, everything is very tiny, and that can be discouraging — it looks very uphill. It takes a little while to enter the system and understand what's going on through keyholes; one has to be patient, because it has a steep learning curve and the margin of error is not there. So for the last four years I've run a dedicated fellowship national training program for spine fellows — once they're selected and come to me, they don't have the option to go to any other theatre, because they're now committed to spine surgery for the rest of their life.
I wanted to share how Paulina has been doing since her surgery with you — honestly speaking, I was really impressed by her recovery time. She's come back to Ghana and she's always praising your team, and now I have even more patients lining up who also want to come and have a consultation, and possibly the surgery, after hearing about her experience.▼
We feel privileged to be treating your patient, and I hope we have done justice to you, your practice and of course the patient. I think at the end of the day we all have one common goal — we want to see our patients happy. Otherwise you, me and Jivo would not be here on a Sunday evening, leaving our families aside, if we did not have this goal.
What is the difference between scoliosis and kyphosis?▼
Scoliosis is a sideways curve of the spine, while kyphosis is a forward hump. Both can appear from birth or around puberty.
What are the three types of scoliosis?▼
Idiopathic scoliosis, the most common type, usually appears around puberty and is about seven times more common in girls. Congenital scoliosis is caused by a hemivertebra, a half-formed vertebra present from birth. Neuromuscular scoliosis occurs in children with conditions such as cerebral palsy or spinal muscular atrophy, producing a C-shaped spinal curve.
What early physical signs suggest a child may have scoliosis?▼
Uneven shoulders, a head that is not centred above the pelvis, one hip appearing more prominent, a limp, a rib hump on one side of the back, or an uneven waist can all suggest scoliosis.
Can skin changes on a child's back indicate a spinal problem?▼
Yes. Dimples, hairy patches or colour changes over the spine can point to spina bifida or a related syndromic condition.
Why does early detection of scoliosis matter?▼
Scoliosis and kyphosis are far easier to treat, and far less invasive to correct, when caught before the curve becomes severe.
In This Series: Spinal Surgery: Advances in Techniques & Technology for Excellent Patient Outcomes
- 1.Advances in Spinal Surgery
- 2.Biportal Endoscopic Spine Surgery: What It Is and How It Works
- 3.Cervical Disc Replacement: Treating Neck Disc Herniation While Preserving Motion
- 4.Growth Rods for Early-Onset Scoliosis in Young Children
- 5.Hemivertebra: Why Early Surgery Prevents Severe Spinal Deformity
- 6.Herniated Disc Surgery: Biportal Endoscopic Discectomy Explained
- 7.Kyphoplasty for Osteoporotic Spinal Fractures: A Same-Day Procedure
- 8.Lumbar Canal Stenosis: Symptoms and Modern Minimally Invasive Treatment
- 9.Minimally Invasive Spinal Fusion: Treating Spinal Instability Without Open Surgery
- 10.Minimally Invasive vs Open Spine Surgery: How Techniques Have Evolved
- 11.Navigation and Robotics in Spine Surgery: Why They Improve Accuracy and Safety
- 12.Prolonged Sitting and Disc Degeneration: Why Desk Jobs Are a Spine Risk
- 13.Recovery After Minimally Invasive Spine Surgery: What Patients Can Expect
- 14.Robotic Spine Surgery for Complex and Revision Cases
- 15.Scoliosis and Kyphosis in Children: Types and Warning Signs
- 16.Scoliosis Treatment: When Observation, Bracing or Surgery Is Needed
- 17.Vertebral Column Resection: Correcting Severe Spinal Deformity From Neglected Tuberculosis
- 18.When to See a Spine Specialist: Warning Signs You Shouldn't Ignore