What is Kyphosis?
Kyphosis can refer to the normal curvature of the spine. However, this information is about abnormal kyphosis, which is spinal curvature causing a hunchback or slouching posture. This spinal disorder generally affects the thoracic spine and sometimes the cervical spine. Kyphosis can cause back pain, muscle fatigue, and stiffness on the mild side of the spectrum. In severe cases, it can cause chest pain and make breathing difficult.
Are There Different Types of Kyphosis?
There are three types of kyphosis: Postural, Scheuermann’s, and congenital kyphosis.
Postural Kyphosis: This is the most common form of kyphosis, and is caused by poor posture. Postural kyphosis usually occurs in adolescents, and presents itself in girls more than boys. In most cases, this type of kyphosis can be corrected with physical therapy and exercise, and doesn’t require any medical treatment.
In the picture below, scoliosis is shown as a sideward abnormal spinal curvature. Kyphosis, on the right side is demonstrated as a hump-like curve in the upper back.
Scheuermann’s Kyphosis: This type of kyphosis also starts in adolescence and is caused by a “wedging” of the vertebrae which can contribute to the development of scoliosis. X-rays are required to identify this type, but doctors aren’t sure why it occurs.
- Scheuermann’s kyphosis can be treated with physical therapy and mild pain medications most of the time.
- If the patient is still growing and the spine curve measures 45-degrees, a brace is recommended.
- Kyphotic spinal curves that measure greater than 75-degrees may require surgery to treat the deformity and stabilize the spine.
Congenital Kyphosis: This is the rarest form of kyphosis. Congenital kyphosis (found at birth) is caused by abnormal development of the vertebrae before birth, and can cause vertebrae to fuse together. Surgery is usually recommended when kyphosis affects an infant, and can help treat the disorder before it worsens.
Kyphosis can be caused by other disorders, including:
- Vertebral compression fracture(s)
- Degenerative spinal arthritis
- Ankylosing spondylitis
- Spinal infection
- Muscular dystropjy
- Spinal tumor
How Do You Know When You Have Kyphosis?
Symptoms may include fatigue, mild back pain, a rounded upper back appearance, spine tenderness and/or stiffness. In more severe cases, patients report shortness of breath, chest discomfort or pain, and/or numbness, weakness and/or tingling in the legs.
Does Kyphosis Need Treatment?
A spine specialist can determine if your kyphosis requires treatment. The evaluation includes your medical and family history, an in-depth physical and neurological examination, and imaging tests. The orthopaedic spine surgeon or neurosurgeon may order standing x-rays, CT scan, and/or magnetic resonance imaging (MRI) to fully assess the kyphosis. If previous imaging studies of the kyphosis are available, the spine specialist will compare the older images to the newest.
The imaging studies are used to measure the size or angle of the kyphosis. Previous imaging studies can lend information about curve size progression—and answer the question, “Is the curve growing larger?”
Furthermore, the balance of your body, ability to stand up straight, and symptoms are potential indicators that nonsurgical or surgical treatment may be recommended. Other tests may include blood work, pulmonary function testing (measure lung capacity), and bone mineral density testing.
Can Kyphosis Be Prevented?
Unless the kyphosis is caused by poor postural habits, the onset cannot be prevented. However, early treatment can help prevent kyphosis from progressing and causing spinal deformity.
What Is the Prognosis for Most Patients?
Most patients respond well to a combination of physical therapy, exercise, and medication. Even in cases that eventually require surgery, most patients are able to return to normal activities without restrictions.