Description
Kyphosis is a progressive spinal disorder that can affect children or adults. This disorder may cause a deformity described as humpback or hunchback. Abnormal kyphotic curves are more commonly found in the thoracic or thoracolumbar spine, although they can be cervical.
The spine's natural curves position the head over the pelvis and work as shock absorbers to distribute mechanical stress during movement. Kyphosis in the thoracic (middle) spine means there is an exaggerated kyphotic curve compared to a normal kyphotic curve. Normal lordotic curves in the cervical (neck) and lumbar (lower back) regions may also be diminished to contribute to the overall pitched-forward posture.
Types
- Postural: attributed to poor posture, usually presenting a smooth curve, which can be corrected by the patient.
- Structural: caused by an abnormality affecting the bones, intervertebral discs, nerves, ligaments, or muscles. Structural kyphosis may require medical intervention because the patient alone cannot control curve progression.
- Gibbus deformity: The posterior (from behind) curve is sharply angled and the curvature is not smooth. This deformity may result in a humpback found to be more prominent when bending forward.
- Hyperkyphosis: An 'excessive' (hyper) curvature exceeding the normal range. Hyperkyphosis occurs in the thoracic spine.
- Congenital: the disorder is found at birth.
- Scheuermann's Disease: This disease can cause decreased intervertebral disc space and vertebral wedging resulting in an excessive curve described as stiff or rigid. The classic definition of Scheuermann's is anterior (front) vertebral wedging of at least 5 degrees involving three consecutive vertebrae. The neck and head may present in an abnormal forward position. The onset usually begins (or is noticed) between the ages of 12 and 15 years affecting females more often than males.
Symptoms
- Pain
- Stiffness
- Hunchback/Humpback/roundback deformity
- Muscle fatigue
Causes
- Neuromuscular disorders
- Secondary to trauma, tumors, infection, and arthritis
- Heredity
- In Scheuermann's Disease, the cause is unknown.
Risk Factors
- Age- adolescence and geriatric
- Gender (occurs more commonly in females)
- Poor posture
- Paraspinal muscle weakness
- Osteoporosis
- Arthritis
- Spinal infection
- Spinal tumors
Diagnosis
- Your doctor will discuss your symptoms, review your medical history, and perform a thorough physical examination of your back.
- X-rays: Show the angle of the vertebrae and identify any wedging vertebrae.
Treatment
Kyphosis is most commonly treated with non-surgical methods, however, there are surgical options for severe cases. Early treatment intervention is particularly important for the adolescent patient. If left untreated, the curve progression can lead to significant problems during adulthood. Routine evaluations are necessary to properly monitor curve progression.
- NSAIDs and analgesics
- Physical therapy
- Postural adjustments
- Cervical Thoraco Lumbar Sacral Orthotic (CTLSO)
- Adolescents
- To be worn 24 hrs per day for one year
