Kyphosis

What is kyphosis?

Kyphosis, similar to scoliosis, is when abnormal spine curvature causes rounding of the upper back, also known as a hunchback. The thoracic (upper- and middle-back) part of the spine normally has a “C”-shaped curve, but when the spine has an extreme forward curve, it leads to kyphosis. Kyphosis most commonly affects the thoracic spine, but can also involve the cervical (neck) and lumbar (lower back) portions.The two most common types of kyphosis are: Scheuermann's kyphosis and postural kyphosis.

Symptoms

The symptoms of kyphosis may vary based on how severe they are. They may range from a minor change in the shape or appearance of the back to more severe nerve problems and long-lasting back pain. There may be weakness in the legs because of the pressure that is put on the spinal cord and nerve from the spinal curvature. Trouble breathing may also develop because of pressure over the lungs.

Evaluations and diagnostic tests may include:

  • Complete medical history.
  • Physical examination by a doctor to evaluate spine movement, muscle strength, and sensation. This helps the doctor make a proper diagnosis and also rule out other similar conditions.
  • Some diagnostic tests such as X-rays, a magnetic resonance imaging (MRI) scan and computed tomography (CT) scan may be ordered to see the structure of the spine and measure the curve.

Possible causes

Kyphosis may develop because of:

  • Metabolic problems
  • Neuromuscular conditions
  • Spina bifida
  • Osteoporotic fractures
  • Traumatic injuries
  • Slippage of vertebral disc

In the case of Scheuermann's kyphosis, the exact cause is not known. 

Treatment

Kyphosis has several treatment choices that range from the most conservative methods to surgery that corrects the spine. Conservative treatment is most often the first choice and includes:

  • Medicines
  • Exercises
  • Casts and support braces for the spine

In cases where osteoporosis causes kyphosis, it’s recommended that your child does the following to slow down the condition’s progress:

  • Take vitamin D and calcium supplements.
  • Use hormone replacement therapy.
  • Do regular exercises.

Physical Therapy and Rehabiliation

Even when the kyphosis curve cannot be corrected with exercise, your child can have hope that the pain can still be relieved. Physical therapy sessions may be scheduled for two to three times a week and should go on for up to six weeks.

Physical therapy exercises and a rehabilitation program can help: 

  • Control pain.
  • Improve strength and mobility.
  • Make it easier to perform daily activities.

Surgery

Spinal surgery is considered a last treatment choice, because of the risks and complications that may happen. It is only recommended when the benefits of the surgery outweigh the risks.

Surgery may be considered if: 

  • There is chronic severe pain.
  • The curvature progresses to a more severe form.
  • There are cosmetic reasons.

The goal of surgery is to straighten the spine and join the vertebrae to form a solid bone, which would reduce the deformity. Like the methods used in scoliosis surgery, metal screws and rods are typically used to hold the vertebrae in place during the fusion.