Kraus Back & Neck Institute: 281.446.3876(281.44.Neuro)

Conditions

Kyphosis

Kyphosis is a natural curve in your thoracic (mid back) spine important to spinal stability, flexibility and fluid movement. In addition, kyphosis can mean abnormal curvature of the spine that can cause shoulders to slump or hunchback. It affects children and adults. Kyphosis can lead to a pitched forward posture, pain, and interfere with your posture and balance.

Kyphosis more commonly affects the thoracic spine. Sometimes kyphosis develops in the cervical (neck) or lumbar (low back).

Types

Similar to other spinal disorders, kyphosis can be very mild and require no treatment, or range from moderate to severe. There are several types of kyphosis.

Type of Kyphosis Description
Congenital (rare) Present at birth, usually a structural abnormality
Postural Poor posture contributes to the development of kyphosis
Structural Abnormality affects the spine's bones and soft tissues
Post-traumatic Trauma, such as spinal fracture
Scheuermann’s Kyphosis Juvenile or adolescent thoracic kyphosis
Age-related Certain degenerative disorders cause or contribute to kyphosis

The causes of kyphosis are closely related to the type of kyphosis. Chronic poor posture can lead to kyphosis, but so can structural changes, of which there are many causes.

  • Degenerative disc disease
  • Compression fracture (osteoporosis, trauma)
  • Spondylosis (spinal arthritis)
  • Spondylolisthesis (low back)

Other disorders that can cause kyphosis include:

  • Spinal infection, tumor
  • Muscular Dystrophy, Cerebral Palsy
  • Paget's disease (bone disorder)
  • Endocrine disease*

*Endocrine disorders can disrupt your body's metabolism, which may include your body's ability to normally rebuild bone.

Symptoms

  • Back pain
  • Stiffness
  • Tender to the touch
  • Round back or humpback appearance (spinal deformity)
  • Clothing does not fit properly
  • Fatigue
  • Difficulty breathing (severe kyphosis)

Accurate diagnosis

The spine specialist's examination includes your medical history, physical and neurological examination, and imaging studies. Because some spine disorders run in families (inherited, genetic predisposition), your family history is important.

Physical examination provides the doctor with a general health and spinal assessment baseline to help estimate the possibility for kyphosis to progress.

  • Heart and lung function
  • Physical appearance (posture, humpback)
  • Palpation: feel the spine through the skin on the back
  • Range of Motion: flexion, extension, bending, rotating
  • Adam's Forward Bending test: bending forward at the waist with the arms extended forward, the doctor checks for shoulder blade, rib, or other prominence

Neurologic examination is an assessment of your reflexes and tests for muscle weakness, loss of feeling, and signs of neurological injury.

A simple spinal x-ray can show kyphosis. Typically, several x-rays are taken: side (lateral), standing (front and back), bending forward (flexion) and bending backward (extension). The flexion/extension studies help your spine specialist to evaluate your range of motion and spinal stability. Special measurement techniques are used to calculate the kyphotic curve's angle(s), patient's skeletal maturity, risk for progression, and other characteristics.

Other diagnostic imaging studies may include a CT or MRI series. A MRI study is of particular use to assess nerve and/or spinal canal (cord) compression. Your doctor will explain the purpose of these and other tests.

Treatment

Whether your spine doctor recommends non-operative or surgical treatment depends on many factors, including the type and cause of your kyphosis. Observation, spinal bracing, and other conservative treatments may help relieve non-structural symptoms. However, congenital and large kyphotic curves typically require spine surgery to stop curve progression, manage deformity, provide a degree of correction, and stabilize the spine.

Surgical treatment of kyphosis may include spinal instrumentation and fusion. You may be a candidate for a minimally invasive spine surgery. There are different ways the surgery can be performed, and your surgeon explains the possible benefits and risks associated with his surgical recommendations.

We hope this information about kyphosis has answered some of your immediate questions. Remember, your doctor is your most valuable source to answer your questions about symptoms and your spine health.

Gary Kraus, MD,
Neurosurgeon, is Board Certified
Meet Gary Kraus, MD
Masaki Oishi, MD,
Spine Fellowship at the University
Meet Gary Kraus, MD
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