ABSTRACT – Kyphosis is an abnormal curving and excessive rounding of back and spinal bones which affects the overall...
Kyphosis
Kyphosis is an exaggerated, forward rounding of the back. It can occur at any age but is most common in older women.
Age-related kyphosis is often due to weakness in the spinal bones that causes them to compress or crack. Other types of kyphosis can appear in infants or teens due to malformation of the spine or wedging of the spinal bones over time.
Mild kyphosis causes few problems. Severe kyphosis can cause pain and be disfiguring. Treatment for kyphosis depends on your age, and the cause and effects of the curvature.
Symptoms:
Mild kyphosis may produce no noticeable signs or symptoms. But some people experience back pain and stiffness in addition to an abnormally curved spine.
Causes:
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.
Diagnosis
Your doctor will generally conduct a thorough physical examination, including checking your height. You may be asked to bend forward from the waist while your doctor views your spine from the side. Your doctor might also perform a neurological exam to check your reflexes and muscle strength.
After evaluating your signs and symptoms, your doctor may recommend:
X-rays or CT scans. X-rays can determine the degree of curvature and detect deformities of the vertebrae. A CT scan might be recommended if your doctor wants more-detailed images.
MRI. These images can detect infection or a tumor in your spine.
Nerve tests. If you are experiencing numbness or muscle weakness, your doctor may recommend tests to determine how well nerve impulses are traveling between your spinal cord and your extremities.
Bone density tests. Low-density bone can worsen kyphosis.
Treatment
Kyphosis treatment depends on the cause and severity of your condition.
Your doctor might suggest medication, including:
Pain relievers. If over-the-counter medicines — such as acetaminophen (Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve) — aren’t enough, stronger pain medications are available by prescription.
Osteoporosis medications. Bone-strengthening medications may help prevent additional spinal fractures that would worsen your kyphosis.
Therapy can help manage certain types of kyphosis. Your doctor might recommend:
Exercises. Stretching exercises may help improve spinal flexibility and relieve back pain.
Bracing. Children who have Scheuermann’s disease may be able to stop the progression of kyphosis by wearing a body brace while their bones are still growing.
Surgery might be recommended for severe kyphosis that is pinching the spinal cord or nerve roots. Spinal fusion is the most common procedure for reducing the degree of curvature. The surgeon inserts pieces of bone between the vertebrae and then fastens the vertebrae together with metal rods and screws until the spine heals together in a corrected position.
To help you maintain good bone density, your doctor might recommend:
Eating a diet rich in calcium and vitamin D
Avoiding tobacco
Limiting alcohol consumption
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