What is kyphosis?

Kyphosis, also called round back or hunchback, is a spinal disorder that occurs when the upper back becomes abnormally rounded forward. 

Kyphosis is a common condition that affects more than 3 million people per year in the United States. It is most common in older women. In early stages of kyphosis, you may not experience symptoms and may not need treatment. If left untreated, kyphosis can become severe and cause significant spinal deformity.

The goal of treating kyphosis is to prevent further curving and relieve symptoms, but it cannot be cured.

Types of kyphosis 

There are three types of kyphosis:

Postural kyphosis

Postural kyphosis is characterized by spinal curvature of more than 50 degrees. Patients who suffer from postural kyphosis can improve with exercises.

Scheuermann’s kyphosis

Scheuermann’s kyphosis, or Scheurmann's disease, is a juvenile form of kyphosis that typically affects teenagers. The vertebrae form into a wedge shape during Scheuermann’s kyphosis to give the hunchback appearance of the spine. The condition affects a very small percentage of the population and can worsen as the spine grows. 

Congenital kyphosis

Congenital kyphosis is a rare spinal deformity present at birth that is characterized by an outward curve of the spine. As the child grows, the outward curvature becomes more noticeable.

Causes of kyphosis

A variety of conditions can cause kyphosis including:

  • Osteoporosis — Osteoporosis is a bone condition that occurs as the bones lose density. It is common cause of kyphosis in older women.
  • Degenerating discs — As people age, the discs between the vertebrae can dry out and shrink. When this occurs, kyphosis can worsen.
  • Scheuermann’s disease — Scheuermann’s disease affects children during a growth spurt before puberty. As the child grows, the back rounding may worsen.
  • Spinal birth defects — some babies are born with spinal defects where the spine did not properly form in the mother’s womb.
  • Cancer treatments — cancer in the spine can affect the spinal vertebrae, which can lead to compression fractures and kyphosis.

Risk factors for kyphosis

The main risk factors for developing kyphosis include:

  • Age — kyphosis is most common in older women
  • Genetics — if a family member had kyphosis, you are more likely to develop it later in life as well
  • Osteoporosis — people with osteoporosis are more likely to develop kyphosis as the condition worsens

Symptoms of kyphosis

If you have a mild case of kyphosis, you may not experience any symptoms. As the condition progresses, symptoms of kyphosis will vary depending on the severity of the curvature as well as the cause of your case.

Symptoms of kyphosis may include:

  • Shoulders that are rounded downward
  • Hump on the back
  • Back pain
  • Fatigue
  • Stiffness in the spine
  • Tight hamstrings

In rare cases, patients may lose sensation or feel weakness or tingling in their legs.

Diagnosis for kyphosis

Kyphosis is diagnosed in a physical exam with a primary care doctor or spine specialist. During the physical exam, your doctor will take a full medical history, evaluate your symptoms and order diagnostic imaging testing. Diagnostic image testing could include:

  • X-ray — an X-ray can take detailed images of the spine to determine if the curvature of the spine is greater than 50 degrees. 
  • CT (computed tomography) scan — a CT scan can produce detailed, cross-sectional images of the spine.
  • MRI (magnetic resonance imaging) scan — if your doctor suspects another condition is causing your symptoms, such as a spinal tumor or infection, he or she may order a MRI scan, which will produce detailed images of the bone and soft tissues around the spine.

If kyphosis is diagnosed and treated early, outcomes are more successful. 

Treatment for kyphosis

Your spine care specialist will develop a treatment plan individualized for your specific case. Often, doctors will start you on over-the-counter or prescription pain relievers or osteoporosis medications. Osteoporosis medications can help prevent the progression of the condition by strengthening the bones.

Other treatment options for kyphosis include:

  • Physical therapy — physical therapy focusing on exercises and stretches that strengthen your back and build the core can help improve posture.
  • Lifestyle treatments — maintaining healthy weight and activity level can help prevent kyphosis from worsening.
  • Braces — children or adolescents who are still growing may correct the condition by wearing braces.

In severe cases, surgical treatment may be an option, including:

Spinal fusion
Patients who are not experiencing symptom relief with conservative treatments, are in severe pain and have a curvature of more than 75 percent, may require surgical intervention to correct kyphosis. Posterior spinal fusion is the most common surgery to treat kyphosis. During the surgery, your doctor will use hardware to fuse the spine together.

Kyphoplasty is a last resort surgical treatment option for kyphosis. During this procedure, a balloon is inserted into the vertebrae and filled with a hardening liquid to straighten the spine.

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