Kyphosis

What is Kyphosis?

Kyphosis is a condition of abnormal curvature of the spine that causes rounding of the upper back or a hunchback. The thoracic portion of the spine normally has a C-shaped curve, but excessive forward curve in the spine leads to kyphosis. Kyphosis most commonly affects the thoracic spine, but can involve the cervical and lumbar portions too.

Causes of Kyphosis

In adults, kyphosis may develop because of degenerative diseases such as arthritis, disc degeneration, osteoporotic fractures, traumatic injuries and slippage of vertebral disc.

Symptoms of Kyphosis

The symptoms of adult kyphosis may vary based on the severity, ranging from a minor change in the shape or appearance of your back to more severe nerve problems and long-lasting back pain. There may be weakness in the legs because of the pressure exerted on the spinal cord and nerve from the spinal curvature. Difficulty in breathing may also develop because of pressure over the lungs.

Diagnosis of Kyphosis

Your doctor will review your family history, symptoms and past medical history (whether you have undergone spinal surgery in the past). Then, a careful physical examination is conducted to evaluate your spine movement, strength of the muscles, and sensation to rule out other similar conditions. Imaging tests such as X-rays, MRI scan and CT scan will be ordered to view the structure of the spine and measure the curve. The MRI and CT scan help to identify nerve and spinal cord abnormalities.

Treatment Options for Kyphosis

Adult kyphosis has several treatment options ranging from conservative methods to surgical correction of the spine. Conservative treatment is most often the first choice and includes medications, exercises, casts and support braces to the spine.

In cases where osteoporosis is the cause of kyphosis, slowing its progression is recommended with the intake of vitamin D and calcium supplements, hormone replacement therapy and regular exercises.

Physical therapy including exercises and rehabilitation helps to control pain, improve strength, mobility as well as easily perform daily activities. You can expect relief from pain even when the kyphotic curve cannot be rectified with the help of exercises. Physical therapy sessions may be scheduled 2-3 times in a week and should be continued for up to six weeks.

Spinal surgery is considered as the last treatment option due to the risks and complications that may occur and is recommended if the benefits of the surgery outweigh the risks. The situations in which surgery for kyphosis may be considered include:

  • Chronic severe pain
  • Progression of the curvature to more severe form
  • Cosmetic reasons

The goal of surgery is to straighten the spine and join the vertebrae to form a solid bone; thus reducing the deformity. Metal screws, plates or rods are used to hold the vertebrae in place during the fusion.

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Dr. Sherief Elsayed

Consultant Orthopaedic Surgeon Subspecialist: Spine Surgery

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The diagnosis of scoliosis involves the review of your family and medical history along with a physical and neurological examination. Physical examination involves palpation of the spine, Adam’s forward bending test and plumb line test. A neurologic examination involves the evaluation of any signs of neurological injury such as numbness, muscle weakness or abnormal reflexes. X-ray of the spine in different positions, such as standing and bending forward, is also ordered. Other specific tests for diagnosing scoliosis include a measure of the degree of spinal curve (scoliometer), degree of vertebral rotation and skeletal maturity. Additional tests to identify the cause of scoliosis may also be conducted.