The spinal column is composed of four precise curvatures that are important in providing the balance, flexibility and absorption of stresses encountered on a daily basis. In some people, abnormal curvatures are present, resulting in conditions such as kyphosis, scoliosis or lordosis. In kyphosis, the upper portion of the spine is affected with an exaggerated curvature or rounding.
Identification
Kyphosis is a progressive spinal disorder by which the upper portion of the spine has a forward rounding, resulting in abnormal stature and other complications. Some forward rounding of the back is normal, but with kyphosis, also called hunchback, the degree of curvature is greater than 50 degrees. The condition is rare and in most cases does not cause any problems, but the possibility of serious health problems does exist with severe curvature.
Symptoms
Often in mild cases, no symptoms surface with kyphosis except for the noticeable slouching of the back. In more severe cases, back pain, fatigue and stiffness or tenderness in the spine are common. The abnormal curvature of the spine may also lead to several complications, some of which are severe. The rib cage can press on the lungs, causing breathing difficulties; back pain may be debilitating; or in rare cases, there are negative neurological symptoms associated with the condition.
Causes
Multiple diseases and conditions can cause abnormal curvature of the upper portion of the back, also called the thoracic spine. In adults, causes of kyphosis include osteoporosis, degenerative spinal arthritis, ankylosing spondylitis, connective tissue disorders, infections, spina bifida, cerebral palsy and tumors in the spinal region. When the condition appears in children or adolescents, one cause is the abnormal development of the spine, either due to fused vertebrae or improper bone formation. It may also arise due to the body compensating for another condition in which the upper spine curves outward; in some cases, the cause is still unknown.
Diagnosis
Several tests are used to diagnose kyphosis, such as the forward bend test and spinal imaging. The forward bent test involves bending forward at the waistline so a doctor can examine the spine from the side to detect abnormalities. Spinal imaging involves the use of X-rays to get an unobstructed view of the spine, allowing doctors to detect affected vertebrae and the degree of curvature of the spine. Other tests, such as pulmonary or neurological functioning tests, may be used to assess if breathing or neurological symptoms are present.
Treatment
The type of treatment for kyphosis depends on the severity of the disease. Less-severe cases may not need any treatment at all, with just some monitoring of the condition to ensure it's not worsening. Other treatments may be postural training and strengthening of the back muscles or the use of beds that are firmer to provide more support. More severe cases generally call for special braces or as a last resort, surgery. In children and adolescents, back braces may help in slowing or preventing the curvature from getting worse and in most cases do not cause any restrictions in normal activities or movement. In adults, braces are primarily used to alleviate or control any back pain associated with the condition. Spinal fusion surgery is the most common procedure used to reduce the degree of curvature of the spine, in which a surgeon joins the affected vertebrae together. Vertebroplasty and kyphoplasty are two more recent surgeries that involve injecting an inert cement substance into the vertebrae to reduce curvature.
