Kyphosis: An Overview

Spinal Deformities - KyphosisThe human spine has normal curves when viewed from the side. These curves known as kyphosis and lordosis helps distribute the mechanical stress of the body throughout. Normal lordosis refers to an inward curvature in the neck (cervical) and lower back (lumbar) region. Normal kyphosis refers to the outward curvature of the spine. The normal curves in the spine permit the body to be balanced over the pelvis. An improperly balanced spine can lead to issues such as back pain, stiffness, and an altered gait or abnormal walking pattern.

Abnormal kyphosis is a term that describes an excessive curvature of the spine that causes the back to have a rounded appearance. Most affected patients present with a hump or “hunchback”. Individuals may complain of back pain, fatigue, and stiffness of the back. In severe cases, symptoms may worsen and can lead to compression of the spinal cord. This can lead to weakness, loss of sensation, and loss of control in the affected area. In cases of thoracic kyphosis, constriction of the chest cavity can occur and cause heart and lung issues.

 

Causes & Types

There are three main causes or types of kyphosis.

Postural kyphosis – is caused by poor posture and is most commonly found in girls compared to boys. It usually starts in adolescence where the poor posture leads to the weakening of muscles and ligaments. Pain and muscle fatigue can be a common symptom. Postural kyphosis does not lead to a severe issue and hence, has a low risk of nerve, heart, or lung issues.

Scheuermann’s kyphosis – is usually noticed when the patient is in their adolescent years. This type of kyphosis is due to the structural deformity of the vertebrae. The diagnosis involves using X-rays to show a wedge of at least 5 degrees in at least three neighboring vertebral bodies. The cause of the structural deformity is not well understood.

Congenital kyphosis – is the least common cause of excessive kyphosis. It happens during the development of the fetus. The abnormal development may lead to multiple vertebrae fused together.

Others – there are other causes and types of excessive kyphosis. These conditions lead to compression fractures of the vertebrae and cause destabilization and collapse.

 

Management

Patients should seek medical attention if they experience symptoms such as weakness, numbness, and pain. The diagnosis of these conditions is based on patient history, physical examination, and imaging (X-ray or magnetic resonance imaging(MRI)) of the spine.

Treatment depends on the type or cause of kyphosis. For postural kyphosis, it can be treated using physical therapy as it helps strengthen the muscles and corrects the posture. Scheuermann’s kyphosis can also be treated through physical therapy and rehabilitation. Braces can be effective for patients who are still growing. Pain relievers and anti-inflammatory medication can be used for patients who experience pain and discomfort. In severe cases, surgery is a viable option as it helps correct the deformity, relieve pain and improve the spinal alignment. For congenital kyphosis, treatment often involves surgery while the patient is an infant to correct the kyphosis to prevent it from worsening.

 

References:

Eck JC. Kyphosis. Medicine Net. Accessed 7/15/2017.

Scoliosis & Kyphosis. Orthopaedic & Neurosurgery Specialists. Accessed 7/15/2017.