The Bend Behind Kyphosis

Symptoms and diagnosis for Kyphosis

By Neurosurgery Singapore


What is Kyphosis?

A normal spine, when viewed from behind, appears straight. However, a spine affected by kyphosis shows evidence of 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, a diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues, bones and organs onto film. The normal spine can bend from 20 to 45 degrees of curvature in the upper back area. This is a type of spinal deformity.

What are the main causes of Kyphosis?

There are several types of kyphosis. The factors that contribute to it vary depending on the type someone has.

  • Fractures. Broken vertebrae can result in curvature of the spine. Compression fractures, which can occur in weakened bone, are the most common. Mild compression fractures often don’t produce noticeable signs or symptoms.
  • Osteoporosis. Weak bones can cause spinal curvature, especially if weakened vertebrae develop 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 flatten 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.
  • Other problems. Spinal bones that don’t develop properly before birth can cause kyphosis. Kyphosis in children can also be associated with certain medical conditions, such as Ehlers-Danlos syndrome.

What are some symptoms of Kyphosis?

Kyphosis condition can vary in seriousness. Generally speaking, the greater the curve of the spine, the more severe the symptoms are.

The symptoms can include:

  • rounded shoulders or a hump on your back
  • back pain or stiffness
  • feeling tired or fatigued
  • tight hamstrings

Although rare, more severe symptoms can occur as the spine continues to curve over time and compress other parts of the body, such as the lungs, nerves, and digestive tract.

Severe complications can include:

  • persistent back pain
  • increased trouble with physical tasks such as walking, looking upwards, or getting up from a sitting position
  • feelings of numbness or tingling in the legs
  • shortness of breath or trouble breathing
  • digestive issues, such as trouble swallowing or acid reflux
  • problems with control of the bladder or bowels

“Kyphosis appears more often in teenagers, whose bones are growing rapidly. But it can develop any age. It may also develop in older adults. As people age, the vertebrae lose flexibility, and the spine may begin to tilt forward.”

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What types of diagnosis?

Our Spine Specialist will conduct a thorough physical examination, including checking your height. You may be asked to bend forward from the waist while the provider views your spine from the side. You may also undergo a neurological exam to check your reflexes and muscle strength.

Tests that may be ordered include:

  • 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. Using radio waves and a strong magnetic field, MRIs can detect infection or a tumor in your spine.
  • Nerve tests. If you are experiencing numbness or muscle weakness, you may need 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 and often can be improved with medications.

Possible treatment methods?

Treatment would depends on the type of kyphosis and the severity of the curve. Before embarking on any treatment, it is good to consult our specialist to address according to your situation.

Nonsurgical treatment

For postural kyphosis, nonsurgical treatment may help prevent the appearance of the curve from worsening. It can also help people with Scheuermann’s kyphosis if their spinal curve is less than 70–75 degrees.

Nonsurgical treatment may involve:

  • Observation: In cases of mild spinal curve, our doctor may suggest waiting to see if the curve progresses. If it does not and the curve does not cause any other symptoms, no further treatment may be necessary.
  • Physical therapy: This involves specific exercises that strengthen the back and core muscles, and may help to improve posture.
  • Bracing: In some cases of Scheuermann’s kyphosis, our doctor may recommend a spinal brace if the spine is still growing. Spinal braces support the back while the spine grows into a more typical position, preventing progressive curving.
  • Treatment for underlying conditions: If an older adult has osteoporosis, or another condition that is causing the spine to weaken or change shape, then treating the underlying disorder may stop the progression of the curve. When a doctor identifies osteoporosis early, it is treatable. They may recommend vitamin D supplements, weight-bearing exercise, or for females, hormone therapy.

Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce any pain.

Surgical treatment

People with congenital kyphosis, or severe forms of Scheuermann’s kyphosis, may benefit from surgery. The aim of surgery is to reduce the curve of the spine and any associated symptoms, such as pain.

The exact procedure a person receives varies depending on the situation. A common type of surgery is spinal fusion. This involves welding several vertebrae together to form a single segment of bone.

Other surgical procedures for severe conditions involve inserting rods, metal screws, and plates into the spine. This helps stabilize the spine and increase the fusion rate for bone grafting. This can reduce the curvature in the upper spine.

These procedures are major surgeries, so our doctor typically try nonsurgical approaches first, wherever possible.

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