Which statement best describes spinal curvature in children with spina bifida?

• A. Decreased lumbar lordosis and decreased thoracic kyphosis
• B. Increased lumbar lordosis and increased thoracic kyphosis
• C. Decreased lumbar lordosis and increased thoracic kyphosis
• D. Increased lumbar lordosis and decreased thoracic kyphosis

Answer: (B)

In spina bifida, the spine tends to adopt sagittal-plane changes from neuromuscular imbalance, leading to a pattern of increased curvature in both the lower and upper parts of the back. Weak trunk extensors and hip flexor dominance tilt the pelvis forward, which elevates the lumbar lordosis. To maintain balance and head position despite this instability, the upper back often rounds more, producing increased thoracic kyphosis. This combination—hyperlordosis in the lumbar region with hyperkyphosis in the thoracic region—best describes the common spinal curvature seen in these children. Clinically, this pattern can contribute to back pain and postural challenges, guiding rehab focus toward strengthening the trunk extensors, stretching hip flexors, and promoting better posture and stability.