Slightly over 50% of children with Down syndrome have which spinal finding?

• A. Kyphosis
• B. Scoliosis
• C. Lordosis
• D. Spondylolisthesis

Answer: (B)

The main idea is that scoliosis is very common in children with Down syndrome. In this population, the risk of developing a lateral curvature of the spine is quite high, with prevalence slightly over 50% as they grow older. This happens due to factors like generalized ligamentous laxity and hypotonia, and sometimes congenital vertebral anomalies, which together allow or promote a sideways curve to develop and progress during childhood and adolescence. Scoliosis is typically defined on radiographs by a Cobb angle of 10 degrees or more in the coronal plane, and ongoing monitoring is important because progression can occur with growth, sometimes necessitating bracing or surgical intervention if it becomes severe.

Kyphosis, or excessive forward rounding of the thoracic spine, can occur but is not the spinal finding most strongly associated with Down syndrome. Lordosis, an excessive inward curve of the lumbar spine, is also common in many children but does not reflect the characteristic high prevalence seen in Down syndrome. Spondylolisthesis, the forward slippage of a vertebra, is relatively uncommon in this population.