What Is Kyphosis?
The spine has a series of normal curves when viewed from the side. These curves help to better absorb the loads applied to the spine from the weight of the body. The cervical spine (neck) and lumbar spine (lower back) are have a normal inward curvature that is medically referred to as lordosis or "lordotic" curvature by which the spine is bent backward. The thoracic spine (upper back) has a normal outward curvature that is medically referred to as kyphosis or the "kyphotic" curve by which the spine is bent forward.
The spine is normally straight when looking from the front. An abnormal curve when viewed from the front is called scoliosis. Scoliosis can occur from design at birth or from rotation or an abnormal twisting of the vertebrae as from pain.
The normal curves of the spine allow the head to be balanced directly over the pelvis. If one or more of these curves is either too great or too small, the head may not be properly balanced over the pelvis. This can lead to back pain, stiffness, and an altered gait or walking pattern.
What Causes Kyphosis?
Most commonly, kyphosis is postural and represents an exaggerated but flexible curve. Usually postural kyphosis is noted during adolescence and is more common in girls than boys. It rarely causes pain, but exercises to strengthen the abdominal muscles and stretch the hamstrings may improve associated discomfort. Postural kyphosis rarely causes problems into adult life.
Other types of kyphosis can be congenital (present at birth), or due to acquired conditions that may include the following:
osteogenesis imperfecta - also called "brittle bone disease." A condition that causes bones to fracture with minimal force.
Scheuermann's disease - a condition that causes the vertebrae to curve forward in the upper back area. The cause of Scheuermann's disease is unknown and is commonly seen in males.
There Are Several Kinds Of Kyphosis
Primary Structural Kyphosis:
- Scheuermann's kyphosis
Secondary Structural Kyphosis:
- Postural kyphosis
- Nutritional kyphosis
What Are The Symptoms?
The following are the most common symptoms of kyphosis. However, each individual may experience symptoms differently. Symptoms may include:
difference in shoulder height
the head bends forward compared to the rest of the body
difference in shoulder blade height or position
when bending forward, the height of the upper back appears higher than normal
tight hamstrings (back thigh) muscles
Back pain, pain down the legs, and changes in bowel and bladder habits are not commonly associated with kyphosis. A person experiencing these types of symptoms requires further medical evaluation by a physician.
The symptoms of kyphosis may resemble other spinal conditions or deformities, or may be a result of an injury or infection. Always consult your physician for a diagnosis.
Diagnostic procedures may include the following:
- x-ray - a diagnostic test which uses invisible energy beams to produce images of bones onto film.
- computed tomography scan (Also called a CT or CAT scan.) –a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs.
- magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body; can often determine damage or disease in an intervertebral disc, vertebral body, spinal cord, nerve roots, ligaments, and muscle.
- >radionuclide bone scan - a nuclear imaging technique that uses a very small amount of radioactive material, which is injected into the patient's bloodstream to be detected by a scanner. This test shows blood flow to the bone and cell activity within the bone.
- blood tests - Early detection of kyphosis is important for successful treatment. Pediatricians or family physicians, and even some school programs, routinely look for signs that kyphosis may be present.
Specific treatment for kyphosis will be determined by your physician based on:
your age, overall health, and medical history
extent of the condition
your tolerance for specific medications, procedures, and therapies
expectation for the course of the disease
your opinion or preference
The goal of treatment is to stop the progression of the curve and prevent deformity. According to the Scoliosis Research Society, treatment may include:
observation and repeated examinations
Observation and repeated examinations for curves that measure less than 60 degrees on an x-ray. Progression of the curve depends upon the amount of skeletal growth, or how skeletally mature, the child is. Curve progression slows down or stops after the child reaches puberty.
Bracing may be used when the curve measures between 60 to 80 degrees on an x-ray, but skeletal growth remains. The type of brace and the amount of time spent in the brace will be determined by your physician.
In rare instances, surgery is recommended when the curve measures 80 degrees or more on x-ray and bracing is not successful in slowing down the progression of the curve.
What ongoing care is required for patients with kyphosis?
Most patients with kyphosis do not require continued care by a physician. After the initial diagnosis and initiating physical therapy and exercises, the patient will often not need routine follow-up care. Patients that notice a progression of their curve or a worsening of their symptoms should see their doctor for further evaluation.
How Can I Prevent Kyphosis?
Scheuermann's and congenital kyphosis are both the result of a structural problem with the vertebrae. As a result, there is nothing that can be done to prevent these types of kyphosis. Bracings and exercises can help slow the progression of Scheuermann's kyphosis. Postural kyphosis can be prevented or lessened by physical therapy and exercises to strengthen the back muscles.
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