Kyphosis

A normal spine, when viewed from behind appears straight. However, a spine affected by kyphosis has a forward curvature of the back bones (vertebrae) in the upper back area, giving an abnormally rounded or "humpback" appearance.

Kyphosis is defined as a curvature of the spine measuring 50 degrees or greater on an X-ray. The normal spine can bend from 20 to 45 degrees of curvature in the upper back area. Kyphosis is a type of spinal deformity.

Kyphosis can be congenital (present at birth), or due to acquired conditions that may include the following:

• Metabolic problems
• Neuromuscular conditions
• Osteogenesis imperfecta (also called "brittle bone disease"). A condition that causes bones to fracture with minimal force.
• Spina bifida. A neural tube defect.
• Scheuermann disease. A condition that causes the vertebrae to curve forward in the upper back area. The cause of Scheuermann disease is unknown and is commonly seen in males.
• Postural kyphosis. The most common type of kyphosis. It generally becomes noticeable in adolescence and can be associated with slouching versus a spinal abnormality. Exercise is used to help correct posture.

Kyphosis is more common in females than males.

The following are the most common symptoms of kyphosis. However, each person 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 healthcare provider.

The symptoms of kyphosis may resemble other spinal conditions or deformities, or may be a result of an injury or infection. Always talk with your healthcare provider for a diagnosis.

The healthcare provider makes the diagnosis of kyphosis with a complete medical history, physical exam, and diagnostic tests. For a child, the healthcare provider will want to have a prenatal and birth history of the child and ask if other family members are known to have kyphosis. The healthcare provider also will ask about developmental milestones since some types of kyphosis can be associated with other neuromuscular disorders. Developmental delays may require further medical evaluation.

Diagnostic procedures may include the following:

• Blood tests
• X-rays. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. This test is used to measure and evaluate the curve. With the use of a full-spine X-ray, the healthcare provider measures the angle of the spinal curve. A treatment plan can often be made based on this measurement.
• Radionuclide bone scan. A nuclear imaging technique that uses a very small amount of radioactive material, which is injected into the bloodstream to be detected by a scanner. This test shows blood flow to the bone and cell activity within the bone.
• Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of large magnets and a computer to produce detailed images of organs and structures within the body. This test is done to rule out any associated abnormalities of the spinal cord and nerves.
• Computed tomography scan (also called a CT or CAT scan). This is an imaging test that uses X-rays and a computer to make detailed images of the body. A CT scan shows details of the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

Early detection of kyphosis is important for successful treatment. Healthcare providers, and even some school programs, routinely look for signs that kyphosis may be present.

Specific treatment for kyphosis will be discussed with you by your healthcare provider based on:

• Your age, overall health, and medical history
• Extent of the condition
• Your tolerance for specific medicines, 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 minimize deformity. Treatment may include:

• Observation and repeated exams. The child will need observation and repeated exams. Progression of the curve depends on the amount of skeletal growth, or how skeletally mature, the child is. Curve progression often slows down or stops after the child reaches puberty.
• Bracing. If the child is still growing, the healthcare provider may prescribe a brace. The type of brace and the amount of time spent in the brace will be discussed with you by your healthcare provider.
• Surgery. In rare instances, surgery is recommended when the curve measures 75 degrees or more on X-ray and bracing is not successful in slowing down the progression of the curve.

Possible complications of kyphosis depend on the type of kyphosis your child has. With Scheuermann kyphosis, there may be pain with activity or with long periods of sitting or standing.

Kyphosis is a type of spinal deformity. Kyphosis is defined as a curvature of the spine measuring 50 degrees or greater on an X-ray.

• It can be congenital (present at birth), or due to acquired conditions
• It is more common in females.           
• The most common 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
• The goal of treatment is to stop the progression of the curve and minimize deformity

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.