About kyphosis

What is kyphosis?

Kyphosis facts

  • There are three main types of kyphosis: postural, Scheuermann's, and congenital.
  • Most cases of kyphosis do not require any treatment.
  • Physical therapy and exercise are often effective in postural and Scheuermann's kyphosis.
  • Surgery is recommended for congenital kyphosis and more severe cases of Scheuermann's kyphosis.

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 lordosisor "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. In this discussion, the term kyphosis will be used to discuss abnormal kyphosis.

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 bony abnormalities of the spine at birth, growth abnormalities especially with adolescence, degenerative spinal changes in adulthood, or abnormal twisting of the vertebrae because of muscle spasm after an injury.

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 are the symptoms for kyphosis?

Mild kyphosis may produce no noticeable signs or symptoms. But some people experience Back Pain and Stiffness in addition to an abnormally curved spine.

When to see a doctor

Make an appointment with your doctor if you notice an increased curve in your upper back or in your child's spine.

What are the causes for kyphosis?

The individual bones (vertebrae) that make up a healthy spine look like cylinders stacked in a column. Kyphosis occurs when the vertebrae in the upper back become more wedge shaped.

Abnormal vertebrae can be caused by:

  • Fractures. Broken or crushed vertebrae (compression fractures) can result in curvature of the spine. Mild compression fractures often don't produce noticeable signs or symptoms.
  • Osteoporosis. This bone-thinning disorder can cause spinal curvature, especially if weakened vertebrae result in compression fractures. Osteoporosis is most common in older women and people who have taken corticosteroids for long periods of time.
  • Disk degeneration. Soft, circular disks act as cushions between spinal vertebrae. With age, these disks dry out and shrink, which often worsens kyphosis.
  • Scheuermann's disease. Also called Scheuermann's kyphosis, this disease typically begins during the growth spurt that occurs before puberty. Boys are affected more often than girls.
  • Birth defects. Spinal bones that don't develop properly before birth can cause kyphosis.
  • Syndromes. Kyphosis in children can also be associated with certain syndromes, such as Ehlers-Danlos syndrome and Marfan syndrome.
  • Cancer and cancer treatments. Cancer in the spine can weaken vertebrae and make them more prone to compression fractures, as can chemotherapy and radiation cancer treatments.

What are the treatments for kyphosis?

Postural kyphosis can usually be treated with physical therapy to help strengthen the muscles of your back and correct your posture. Mild pain relievers and antiinflammatory medications can also help with symptoms. These curves do not continue to worsen with time or lead to more serious complications. Surgery is not needed for postural kyphosis.

Scheuermann's kyphosis is usually initially treated with a combination of physical-therapy exercises and mild pain and antiinflammatory medications. If the patient is still growing, a brace can be effective. Braces are often recommended for curves of at least 45 degrees and can be continued until the patient is no longer growing. Your physician will likely obtain routine X-rays to monitor the degree of kyphosis over time. Bracing is not typically recommended for adults who are no longer growing.

In some cases, surgery is recommended for Scheuermann's kyphosis. The goals of surgery are to partially correct the deformity of the kyphosis, relieve pain, and improve your overall spinal alignment. Indications for surgery include a curve greater than 75 degrees, uncontrolled pain, and neurologic, cardiac, or pulmonary complaints.

There are various types of surgical procedures available depending on the specifics of each case. Surgery can be performed from the front (anterior approach), from the back (posterior approach), or both (combined anterior and posterior approach). This decision is made by your surgeon based on the specific characteristics of your curve. You may obtain X-rays bending forward and backward to determine how flexible your spine is. If it is flexible, a posterior approach may be adequate. If you are less flexible, you may need an anterior or combined approach. Regardless of the approach, the surgery involves partially straightening your spine and using rods and screws in the vertebrae to hold the spine while a bony fusion occurs.

Treatment of congenital kyphosis often involves surgery while the patient is an infant. This is because the kyphosis is caused by an abnormality in the developing vertebrae. Surgery earlier in life can help correct the kyphosis before it continues to worsen.

Sometimes kyphosis from painful collapse of vertebrae due to osteoporosis is treated with a procedure called a kyphoplasty, whereby a balloon is inserted into the affected vertebra and filled with a liquid (methymethacrylate) that hardens to restore the vertebral height. This procedure is a last resort after failure of noninvasive treatment.

What are the risk factors for kyphosis?

Kyphosis is a condition in which the spine curves abnormally, affecting the upper back and neck. It's most common in older people, but it can occur at any age. Kyphosis can be either congenital (present from birth) or acquired. The most common cause of acquired kyphosis is osteoporosis, which causes bones to become brittle and break easily.

A person with kyphosis may experience pain in the upper back, stiffness in the neck and shoulders, and difficulty moving around because of muscle weakness and bone fragility. If left untreated, kyphosis can interfere with breathing and digestion as well as cause other serious health problems.

There are several risk factors for kyphosis, including:

1. Age: Kyphosis becomes more common as you age.

2. Genetics: Some people are born with genes that make them more likely to develop kyphosis.

3. Bone Density: Having less bone density makes you more likely to develop kyphosis.

4. Anemia: Having low levels of iron (anemia) may increase your risk of developing kyphosis.

5. Obesity: Being overweight increases your risk of developing kyphosis because it causes pressure on the spine and causes uneven weight distribution throughout your body.

6. Injury: Injuries or trauma to your back can cause kyphosis over time if left untreated. For example, after an injury or surgery on your back, it could take weeks before you're able to regain any movement in that area again—and if your doctor doesn't prescribe physical therapy or other treatment during this time period (which is pretty common), then there's a chance that your spine could become permanently curved from being immobile during recovery time.

Symptoms
Lack of appetite,Feeling tired all the time,Excessive thirst and urination,Sleeping problems (insomnia)
Conditions
Scoliosis,Spondylolisthesis (when one vertebrae slips forward over another),Cervical spondylosis (degenerative changes in the neck),Osteoporosis (brittle bones),Rheumatoid arthritis
Drugs
Cortisone injection,Medications that soften the bones, like alendronate (Fosamax) or ibandronate (Boniva),Injections of a steroid medication into the kyphotic vertebrae to reduce inflammation and pain

Is there a cure/medications for kyphosis?

Kyphosis is a condition that causes the spine to curve backward. It can be caused by a number of things, including poor posture, spinal injury, and congenital conditions.

There is no cure for kyphosis. However, there are a number of treatments that can help relieve the symptoms and improve mobility.

Here are some common treatments for a kyphosis:

1. Physical Therapy: This will help strengthen your back muscles and improve your posture.

2. Medications: Some doctors may recommend pain medications or muscle relaxers to help with any pain you are experiencing as a result of your kyphosis.

Medications for kyphosis include:

1. Steroids: Corticosteroids are often used in conjunction with other treatments to reduce inflammation and relieve pain. They are generally considered safe for short-term use, but long-term use may cause complications.

2. Nonsteroidal anti-inflammatory drugs (NSAIDs): These medications help reduce inflammation and pain, but they do not treat the underlying cause of kyphosis. They can cause gastrointestinal problems if taken regularly over time.

3. Antidepressants: These medications can help ease depression associated with kyphosis and other conditions, but they will not treat the underlying problem itself.

4. Bracing: A brace can be used to stabilize your spine while it heals over time or while you're recovering from an injury or surgery related to your condition (e.g., osteoporosis).

5. Bisphosphonates - these drugs are taken orally and help reduce inflammation in the vertebral body (the part at the top of each bone). They can also increase bone density over time so that fusion doesn't occur as much anymore.

Symptoms
Lack of appetite,Feeling tired all the time,Excessive thirst and urination,Sleeping problems (insomnia)
Conditions
Scoliosis,Spondylolisthesis (when one vertebrae slips forward over another),Cervical spondylosis (degenerative changes in the neck),Osteoporosis (brittle bones),Rheumatoid arthritis
Drugs
Cortisone injection,Medications that soften the bones, like alendronate (Fosamax) or ibandronate (Boniva),Injections of a steroid medication into the kyphotic vertebrae to reduce inflammation and pain

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