Your Health - Kyphosis

Kyphosis

(Roundback of the Spine; Congenital Kyphosis; Postural Kyphosis; Scheuermann’s Kyphosis; Hunchback)

Pronounced: ki–fo-sis

Definition

Kyphosis is a rounding or curve to the spine. A certain degree of normal curve is seen in the spine. This article refers to an abnormally rounded back. The abnormal kyphosis is in the thoracic spine (along ribs). The three main types of kyphosis are:

Postural kyphosis—the most common abnormal type and is caused by bad posture
Congenital kyphosis—a type that babies are born with
Scheuermann’s kyphosis—a type that runs in families and appears during the teenage years

The sooner kyphosis is treated, the better the outcome. If you think you may have this condition, contact your doctor.

Kyphosis Posture

Causes

Kyphosis can start at any age. It can have various causes, including:

Bad posture
Arthritis
Fractures of the vertebrae (bones in the spine)
Trauma to the spine
Osteoporosis
Spine infection
Certain diseases:
- Marfan syndrome
- Cancer
- Tuberculosis
- Cerebral palsy
- Polio
Abnormal fetal development
Unknown (Scheuermann’s kyphosis)

Risk Factors

These factors increase your chance of kyphosis. Tell your doctor if you have any of these risk factors:

Marfan syndrome or other tissue disease
Condition that weakens bones, like osteoporosis
Age
- Adolescence for postural or Scheuermann’s
- Elderly with osteoporosis and spine fractures
Sex
- Boys for Scheuermann’s kyphosis
- Girls for postural kyphosis

Symptoms

If you have any of these, do not assume it is due to kyphosis. These symptoms may be caused by other conditions. Tell your doctor if you have any of these:

Excess curve or hump in the back
Back pain
Fatigue in back and legs
Stiffness in back
Breathing difficulty may occur in some cases

Diagnosis

Most cases can be diagnosed during a physical exam. Some cases are found at school during a scoliosis check. Your doctor will ask about your symptoms and medical history. A physical exam will be done to look for abnormal curve in the spine, rounded shoulders, and a hump on the back. Your doctor may refer you to a specialist in spine problems.

Tests may include the following:

X-ray of the spine—test that uses radiation to take a picture of structures inside the body
Pulmonary function tests—measure how well you are able to breath; some severe cases of kyphosis can impair breathing

Treatment

Talk with your doctor about the best plan for you. Options include the following:

Physical Therapy

Your doctor may refer you to a physical therapist to learn specific exercises. This may include strength work, stretching, and overall conditioning. You may also be taught how to maintain a correct posture. You may be instructed to sleep on a firm mattress.

Medications

Nonsteroidal antiinflammatory drugs (NSAIDs) may be given for pain or discomfort. Medicine may be given to treat any underlying conditions, like osteoporosis.

Back Brace

Braces are sometimes used. They can help correct kyphosis or reduce discomfort.

Surgery

Surgery is reserved for severe cases. In this case the spine is straightened by fusing the back bones (vertebrae) together. Surgeons may use bone from the pelvis to fuse the back bones. A metal rod may also be inserted into the spine to help straighten it.

Kyphosis is also sometimes treated with special cement. The cement is injected into the back bones affected.

Prevention

To help reduce your chance of getting kyphosis, take the following steps:

Seek treatment for any bone diseases like arthritis and osteoporosis.
Pay attention to your posture and avoid slouching.

RESOURCES:

American Academy of Orthopaedic Surgeons
http://www.aaos.org/

American Academy of Pediatrics
http://www.aap.org/

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org/

Canadian Orthopaedic Foundation
http://www.canorth.org/

References:

Hu SS, Tribus CB, Tay BK, Bhatia NN. Diagnosis & Treatment in Orthopedics . 4th edition. United States: McGraw-Hill; 2006: Chapter 5. Disorders, Diseases, & Injuries of the Spine.

Kyphosis. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/kyphosis/DS00681 . Accessed November 3, 2008.

Kyphosis. Merck Manual website. Available at: http://www.merck.com/mmhe/sec23/ch278/ch278c.html . Accessed November 3, 2008.

Kyphosis (Roundback) of the spine. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00423 . Accessed November 3, 2008.

Last reviewed September 2009 by Robert E. Leach, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.