The human spine has normal curves when viewed from the side. These curves
known as kyphosis and lordosis helps distribute the mechanical stress
of the body throughout. Normal lordosis refers to an inward curvature
in the neck (cervical) and lower back (lumbar) region. Normal kyphosis
refers to the outward curvature of the spine. The normal curves in the
spine permit the body to be balanced over the pelvis. An improperly balanced
spine can lead to issues such as back pain, stiffness, and an altered
gait or abnormal walking pattern.
Abnormal kyphosis is a term that describes an excessive curvature of the
spine that causes the back to have a rounded appearance. Most affected
patients present with a hump or “hunchback”. Individuals may
complain of back pain, fatigue, and stiffness of the back. In severe cases,
symptoms may worsen and can lead to compression of the spinal cord. This
can lead to weakness, loss of sensation, and loss of control in the affected
area. In cases of thoracic kyphosis, constriction of the chest cavity
can occur and cause heart and lung issues.
Causes & Types
There are three main causes or types of kyphosis.
Postural kyphosis – is caused by poor posture and is most commonly
found in girls compared to boys. It usually starts in adolescence where
the poor posture leads to the weakening of muscles and ligaments. Pain
and muscle fatigue can be a common symptom. Postural kyphosis does not
lead to a severe issue and hence, has a low risk of nerve, heart, or lung issues.
Scheuermann’s kyphosis – is usually noticed when the patient
is in their adolescent years. This type of kyphosis is due to the structural
deformity of the vertebrae. The diagnosis involves using X-rays to show
a wedge of at least 5 degrees in at least three neighboring vertebral
bodies. The cause of the structural deformity is not well understood.
Congenital kyphosis – is the least common cause of excessive kyphosis.
It happens during the development of the fetus. The abnormal development
may lead to multiple vertebrae fused together.
Others – there are other causes and types of excessive kyphosis.
These conditions lead to compression fractures of the vertebrae and cause
destabilization and collapse.
Patients should seek medical attention if they experience symptoms such
as weakness, numbness, and pain. The diagnosis of these conditions is
based on patient history, physical examination, and imaging (X-ray or
magnetic resonance imaging(MRI)) of the spine.
Treatment depends on the type or cause of kyphosis. For postural kyphosis,
it can be treated using physical therapy as it helps strengthen the muscles
and corrects the posture. Scheuermann’s kyphosis can also be treated through
physical therapy and rehabilitation. Braces can be effective for patients who are still growing. Pain relievers
and anti-inflammatory medication can be used for patients who experience
pain and discomfort. In severe cases, surgery is a viable option as it
helps correct the deformity, relieve pain and improve the spinal alignment.
For congenital kyphosis, treatment often involves surgery while the patient
is an infant to correct the kyphosis to prevent it from worsening.