Kyphoscoliosis refers to concomitant kyphosis, i.e., an abnormal anteroposterior curvature of the spine leading to the formation of a hunchback, and scoliosis, which describes a pathological lateral deviation of the vertebral column. Kyphoscoliosis may be congenital or acquired and may interfere with the function of intrathoracic organs. Treatment and prognosis largely depend on the etiology and severity of the disease.
The patient’s age at symptom onset, as well as complaints related to the presence of kyphoscoliosis (KS), depend on the severity of the condition . If not diagnosed prenatally, severe symptoms of congenital KS may be seen at birth. However, mild deformities of the spine may not clinically manifest until years later . In this context, it has been estimated that about 70% of congenital vertebral anomalies result in progressive deformities . Besides the asymmetry of the thoracic wall and the deviation of the vertebral column – which may increase several degrees per year  – KS patients typically claim backaches and the inability to sit or stand for a prolonged period of time. Moreover, they may eventually present with the following comorbidities and sequelae:
Of note, a considerable share of children diagnosed with congenital spine anomalies suffers from additional developmental defects that may affect the cardiovascular or genitourinary system . Thus, pediatric KS patients may present with symptoms unrelated to deviations of the vertebral spine.
Acquired KS may be related to degenerative disease, infectious disease or trauma, or may occur sporadically. While functional impairment of thoracic organs may cause complications as described above, the course of the disease may differ in the progression of the underlying disease.
Developmental defects due to disturbed somitogenesis and impaired formation of the axial skeleton may be detected during prenatal ultrasound examinations . At a later age, vertebral anomalies causing KS may be visualized by means of plain radiography and computed tomography. The single most important advantage of computed tomography scans is the possibility of three-dimensional reconstructions of the vertebral spine . In any case, the presence of single or multiple hemivertebrae and wedge vertebrae, unilateral unsegmented bars, block vertebrae and butterfly vertebrae may be visualized . Magnetic resonance imaging may be indicated to assess the condition of the spinal cord and to identify comorbidities such as diastematomyelia  . Diagnostic imaging may also be employed to depict acquired pathologies of the skeleton, e.g., rickets, osteopenia, and osteoporosis.