What is Kyphosis?
The normal curvature of the spine has a slight “lordosis” (inward curve) in the cervical (neck area) and lumbar (lower back) regions and a slight “kyphosis” (outward curve) in the thoracic (middle) region.
The condition known as “kyphosis” can be thought of as an arching of the spine in the thoracic region beyond normal parameters. This curve could be described as “the kind of curve seen in an angry cat”. It is normal as long as it does not exceed a certain angle or range. Excessive kyphosis in the thorax and any degree of kyphosis in the lower back (lumbar area) or neck (cervical area) are abnormal.
It’s important to understand the kyphosis and scoliosis are two separate conditions. Scoliosis can also affect any part of the spine, but its abnomal curve is noticed when looking at a patient from the front or back, while kyphosis is noticed looking at the person from the side.
Link to AAOS - Kyphosis
What are the signs and symptoms of kyphosis?
Parents and friends of the patient may notice that he or she has "poor posture." This may be more noticeable when the child is bending forward which tends to exaggerate the angle of kyphosis. Back pain may be present, but rarely is severe enough to keep a patient from carrying out normal activities. When present, the pain is located over the tip of the curve in the back. Sometimes, the part of the spine not affected by kyphosis curves in the opposite direction (i.e. the point of the arch toward the front of the body) creating what is called lordosis. Sometimes a small amount of scoliosis can develop as well (see Patient Guide to Scoliosis).
What causes kyphosis?
As mentioned above, kyphosis can be caused by various things. In children with poor postures, the ligaments of the spine can be stretched and the vertebrae form in an abnormal fashion. Of course, poor posture may also be the result of kyphsosis caused by other factors.
In a condition called "Sheuermann's kyphosis," the vertebrae that make up the spine take on a wedged shape instead of the normal cylindrical shape. This usually happens during adolescence and may be due to increased pressure on the growing vertebrae, mild osteoporosis (a decrease in the density of the bones), or by abnormalities in the vertebral growth cartilage.
Congenital kyphosis refers to a curvature that is present at birth. In this condition the vertebral bodies are characterized by a triangular shape and can even be fused together in front.
An increasingly common cause of kyphosis is osteoporosis, especially in the elderly or in patients taking steroids for other medical conditions.
Infections or fractures in the vertebrae can cause structural damage and can also lead to abnormal curvature (i.e. kyphosis).
Colleen Cullen, CRNP
Christopher Fisher, PA-C
Rebecca Perkins, CRNP
Kristen Venuti, CRNP
Peggy Wilckens, MMS, PA-C
Mary Teresa (Tresie) Yost, FNP-C
JH Outpatient Center
601 N Caroline Street
Baltmore, MD 21287
Green Spring Station
10755 Fall Road (Falls & Joppa)
Lutherville, MD, 21093
4924 Campbell Blvd, Suite 130
White Marsh, MD 21236
10700 Charter Drive
Columbia, MD 21044
How is kyphosis treated?
Kyphosis (except for the congenital variety) rarely produces harmful effects on the important organs and structures inside of the body. Treatment is therefore based on the symptoms a patient may be experiencing. For example, for those complaining of pain, exercises and pain relieving medications are used. For those concerned with how the curvature appears, bracing or postural exercises may be used (see Patient Guide to Scoliosis Bracing).
Surgery is only needed in severe cases of curvature. For patients who do not have any complaints about pain or deformity, no treatment is needed.
In congenital kyphosis (i.e. the kind that is present at birth) surgery should be performed if the patient is still growing. The reason that surgery is important in this group is because the curve can worsen over time and cause damage to the spinal cord. Surgical repair and stabilization includes placing spinal hardware along the spine to offer support and reduce curvature.
Kyphosis Before and After Surgery.
Should I see the doctor regularly for kyphosis?
In growing patients, the curve should be monitored every six months. Adults only need to be seen for pain or other questions or concerns.
In general, children with kyphosis live normal lives. Their life expectancy is the same as any other person and they are able to carry about full time jobs later in life. Some, however, may not be able to do jobs that are extremely physically demanding. It is also true that kyphsosis tends to worsen with age and osteoporosis.
For related information, please consult the following web sites:
Scoliosis Research Society: http://www.srs.org
International Scoliosis Research Center: http://www.scoliosishelp.org