Kyphosis is a condition of abnormal curvature of the spine that causes rounding of the upper back or a hunchback. The thoracic portion of the spine normally has a “C”-shaped curve, but an excessive forward curve in the spine leads to kyphosis. In adults, kyphosis may develop as a result of degenerative diseases such as arthritis, disc degeneration, osteoporotic fractures, traumatic injuries and slippage of the vertebral disc. Kyphosis most commonly affects the thoracic spine, but can involve the cervical and lumbar portions too.
The symptoms of adult kyphosis may vary based on the severity, ranging from minor changes in the shape or appearance of your back to more severe nerve problems and long-lasting back pain. There may be weakness in the legs because of the pressure exerted on the spinal cord and nerves from the spinal curvature. Difficulty in breathing may also develop as a result of pressure on the lungs.
Your doctor will take a brief history, which includes family history, history of your present symptoms, and past medical history (whether you have undergone spinal surgery in the past). Then, a careful physical examination is done to evaluate the spine movement, strength of the muscles, and sensation in order to make a proper diagnosis and also rule out other similar conditions. Some diagnostic tests, such as X-rays, MRI scans, and CT scans, will be done to see the structure of the spine and measure the curve. The MRI and CT scans help in identifying nerve and spinal cord abnormalities.
Adult kyphosis has several treatment options, ranging from the most conservative methods to surgical correction of the spine. Conservative treatment is most often the first choice and includes medications, exercises, casts and support braces to the spine.
In cases where osteoporosis is the cause of kyphosis, slowing the progression of osteoporosis is recommended with the intake of vitamin D and calcium supplements, hormone replacement therapy, and regular exercise.
Physical therapy exercises and rehabilitation programs help to control pain, improve strength, mobility and perform daily activities easily. You can expect relief from pain even though the kyphotic curve cannot be rectified with the help of exercises. Physical therapy sessions may be scheduled 2-3 times a week and should be continued for up to six weeks.
Spinal surgery is considered the last treatment option due to the risks and complications that may occur and is recommended if the benefits of the surgery outweigh the risks. The situations in which surgery for kyphosis may be considered include:
The goal of surgery is to straighten the spine and join the vertebrae to form a solid bone and thus reduce the deformity. Metal screws, plates, or rods are used to hold the vertebrae in place during the fusion.
