Kyphosis

Summary

Kyphosis = a hump in the back, from the Greek “kyphos,” hump

Kyphosis is a spinal deformity in which part of the back curves forward, creating the appearance of a hump in the back. The curvature typically exceeds 50 degrees.

Although kyphosis usually develops in the thoracic spine (upper back), it can also develop in the cervical spine (neck) and lumbar spine (lower back). All forms of kyphosis can produce sagittal imbalance, or improper alignment in the front-to-back direction.

Kyphosis is sometimes called hyperkyphosis. Kyphosis is the technical name for the outward curve in the upper back that is present in the normal spine. Hyperkyphosis is therefore sometimes used to denote an abnormally large curvature. However, in most cases, people use the term kyphosis to refer to the abnormal curvature.

Symptoms

Symptoms of kyphosis can range from mild to severe. Symptoms may include:

  • A hunched forward appearance (appears as if one is bending forward)
  • Back pain (mild to severe)
  • Loss of height
  • Difficulty standing straight
  • In severe cases of cervical and thoracic kyphosis, chin on chest syndrome

Causes and Risk Factors

Kyphosis can be caused by a variety of conditions, including:

  • Osteoporosis- a disease in which the bones become fragile and are more likely to break. Kyphosis in adults is most commonly caused by osteoporosis  
  • Congenital deformity – present at birth
  • Degenerative changes in the spine
  • Neuromuscular conditions such as cerebral palsy, spina bifida, or muscular dystrophy
  • Nutritional deficiencies such as vitamin D deficiency
  • Developmental problems such as Scheuermann’s Disease, in which the spine and discs grow at an abnormal rate
  • Trauma such as fractures
  • Spondylolisthesis

Tests and Diagnosis

The doctor will review the complete medical history and perform a physical examination. The doctor will order X-rays, which use invisible electromagnetic beams to produce detailed pictures of the bones of the spine.

The doctor may order additional tests to look at specific parts of the spine. These diagnostic procedures include:

  • Magnetic resonance (MR) imaging – 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.
  • Computed tomography (CT) scan – a diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce images of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

Treatments

The type of treatment depends on the cause and the severity of kyphosis.

For the most part, nonoperative treatments are recommended before surgery is considered. Nonoperative treatments include pain medications, physical therapy, and certain braces.

Surgery is considered if

  • a patient is experiencing severe pain that is not relieved by physical therapy, bracing, and/or pain medications
  • the kyphosis is progressing
  • the kyphosis has resulted in physical deformity and is unbearable to the patient.
  • the kyphosis is congenital
  • the patient has or is at risk for neurological compression due to the kyphosis

The surgeon will determine the best treatment for each individual patient and each situation.

Preparing for Your Appointment

Drs. Peter D. AngevineChristopher E. Mandigo and Sheng-fu (Larry) Lo are experts in treating kyphosis. They can also offer you a second opinion.

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