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
- Surgery
Surgery is indicated when
- The deformity is progressive beyond severe angle (e.g. 70 degrees for Scheuermann's Disease) or sagittal balance is significantly abnormal
- Neurologic symptoms exist
- When persistent pain cannot be alleviated using conservative treatment In addition, adolescents with significant deformity, who may not respond to conservative therapy (e.g. bracing) and adults with curve progression and/or chronic back pain, may be accorded surgery.
Types
- Spinal instrumentation: Instrumentation uses medically designed hardware such as rods, bars, wires, and screws. These devices hold the spine straight during fusion.
- Fusion: Fusion is the adhesive process joining bony spinal elements. In severe cases, spinal fusion is performed both anteriorly (from the front) through thoracotomy (entering chest cavity) and posteriorly (from behind) using instrumentation.
These procedures join and solidify the level where a spinal element has been damaged or removed (e.g. intervertebral disc).
- Kyphoplasty (link to kyphoplasty page) is an innovative technique that combines vertebroplasty with balloon catheter technology developed for angioplasty. The procedure shows great promise in the treatment of painful, progressive osteoporotic or osteolytic vertebral compression fractures. Kyphoplasty is well tolerated and is associated with statistically significant improvements in pain and function.
Goal of surgery
- Correct spinal deformity, relieve pain, improve the overall spinal alignment and provide permanent spinal stability.
Who qualifies?
- Spinal curve greater than 70 degrees whose symptoms are not relieved by conservative methods. Severe cases with neurologic, cardiac, or pulmonary complaints.
