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Adult Kyphosis
Adult Kyphosis describes a type of abnormal curve in the spine. The thoracic spine naturally possesses some kyphosis or a “C” shaped curve. A kyphotic spinal deformity means an unusually large forward curve in the spine. This “C” shape occurs because of wedge-shaped vertebrae that become rigid as the individual grows. Normal vertebrae appear shaped like rectangles and stack on top of each other like a tower of blocks stacked on each other.
Structural Kyphosis
Structural kyphosis, such as Scheuermann’s kyphosis, involves a structural abnormality within the spine itself. Named after the radiologist who first described the condition, Scheuermann’s kyphosis is the most common type of structural kyphosis. Unlike postural kyphosis, where a change in position can help correct the abnormal spinal curve, Scheuermann’s kyphosis cannot be corrected by adjusting posture.
In a healthy spine, the vertebrae are rectangular and neatly stacked, separated by intervertebral discs, maintaining neutral alignment. However, in cases of Scheuermann’s kyphosis, one or more vertebrae are triangular in shape. This causes them to wedge together and curve forward, impacting the biomechanics of the entire spine and impairing its ability to maintain natural alignment and curvatures. This forward-rounding primarily affects the thoracic spine.
Scheuermann’s kyphosis is most commonly diagnosed during adolescence and is more prevalent in boys than girls. Each case can present unique symptoms, but it can be particularly painful during long periods of standing, sitting, or activity. The kyphotic curves in Scheuermann’s are rigid, making them more complex to treat compared to the flexible curves in postural kyphosis.
Questions and Answers
What is Adult Kyphosis?
Adult Kyphosis is a condition in which the upper back curves forward, causing the spine to form an exaggerated “hunchback”. It is a type of spinal deformity that affects adults
What are the Causes of Adult Kyphosis?
The causes of adult kyphosis can be divided into two categories:
- Degenerative kyphosis: This is the most common type of adult kyphosis. It is caused by wear and tear on the spine, which can lead to a loss of flexibility and strength in the spine.
- Idiopathic kyphosis: This type of adult kyphosis has no known cause. It is thought to be caused by a combination of factors, including genetics, muscle weakness, and poor posture.
What are the Symptoms of Adult Kyphosis?
The symptoms of adult kyphosis can vary depending on the severity of the condition. Some of the most common symptoms include:
- A hunchback
- Back pain
- Neck pain
- Fatigue
- Shortness of breath
- Headaches
- Difficulty sleeping
- Depression
- Anxiety
Kyphosis can be painful and primarily cause discomfort in the area of the curvature. When the curve is severe, it can put pressure on the spinal cord, leading to nerve compression. This nerve compression can result in weakness, particularly in the lower extremities.
If kyphosis affects the thoracic spine, the curve can make it difficult to breathe and can impair the function of the lungs and heart. This is due to the reduced space in the chest cavity, which can cause shortness of breath and potentially impact heart function.
In addition to physical symptoms, the condition can also lead to emotional challenges such as depression and anxiety, often stemming from chronic pain and physical limitations.
Understanding these symptoms and their underlying causes is crucial for managing and treating kyphosis effectively.
Adult Kyphosis & Degrees of Severity
Adult kyphosis displays varying symptoms and degrees of severity, from minor changes in the shape of your back to severe deformity, nerve problems, and chronic pain. While kyphosis usually occurs in the thoracic spine, it can also affect the cervical and lumbar spine.
Understanding the differences between structural and postural kyphosis is crucial for effective treatment and management, ensuring that the condition is approached with the appropriate therapeutic strategies.
Understanding the affected areas is crucial for proper diagnosis and treatment, as the symptoms and complications can vary depending on which part of the spine is involved.
Methods have greatly improved over the past decade, and today numerous effective treatment options correct severe kyphotic deformities. Based on a normal curve maintains a 20 to 40 degrees curve along the entire thoracic spine, when the curve reaches more than 40 to 45 degrees, doctors consider the spine deformed. Your Spine Specialist will help you determine which one is the best treatment for you and your condition.
In order to understand symptoms and treatment choices, patients should learn about mid-back anatomy. The thoracic spine is made up of the middle 12 vertebrae of your spine. The normal amount of curve in the thoracic spine is considered to be from 20 to 40 degrees within the entire thoracic spine. There is a range because the amount of ‘normal’ curve varies from person to person.
In order to understand your symptoms and treatment choices, you should start with some basic understanding of the general anatomy of your spine. This includes becoming familiar with the various parts that make up the thoracic spine and how they work together. Understanding these basics can help you better grasp why certain issues arise and what treatment options may be most effective.
Understanding the Appearance of Kyphosis
Kyphosis is a condition that typically becomes visible during the adolescent years and affects more females than males. This condition is characterized by an excessive forward curvature of the spine, making the back round more than normal. The curvature can lead to a noticeable hunch in the upper back, which is often more pronounced when bending forward.
Key Visual Markers:
- Abnormal Back Curve: Unlike the gentle curve seen in a normal spine, kyphosis shows a sharper bend, creating a noticeable hump.
- Postural Changes: The condition may first be noticed by parents who see an unusual curve in their child’s back or may be identified during a health checkup.
An understanding of these visual indicators can prompt earlier consultation with a healthcare provider, ensuring that the condition can be managed effectively. Early diagnosis is crucial in managing kyphosis because it allows for timely and appropriate intervention.
Differentiating Between Postural and Structural Kyphosis
Postural Kyphosis:
- Highly treatable and even reversible if addressed early.
- Involves correcting bad postural habits.
- Incorporates spinal-extension and core-strengthening exercises.
Structural Kyphosis (e.g., Scheuermann’s):
- More complex to treat due to its structural nature.
- Success depends on factors such as condition severity, patient age, and curvature flexibility.
- Requires condition-specific chiropractic adjustments.
- Includes exercises to increase spinal and core strength.
- May involve corrective bracing, particularly for younger patients.
Patient Characteristics:
- Early diagnosis allows for treatments tailored to individual patient characteristics.
- Factors like age, type of kyphosis, and flexibility of the curvature significantly impact the treatment approach.
By addressing these factors early on, patients can experience improved outcomes and a higher likelihood of managing the condition effectively.
When considering kyphosis treatment, one may wonder whether kyphosis is reversible or treatable. The answer largely depends on factors such as the severity of the condition.
In some cases, kyphosis exercises and the use of a kyphosis back brace may help improve posture and alleviate symptoms, particularly in cases of mild to moderate kyphotic curves. Kyphosis treatment aims to address the curvature of the spine, but whether dowager’s hump, a characteristic manifestation of kyphosis, is reversible or treatable depends on various factors and the severity of the condition.
However, more severe instances might necessitate kyphosis surgery, which can provide a more significant correction to reverse thoracic kyphosis and enhance spinal alignment.
It’s important to consult with a doctor to determine the most suitable treatment approach based on the individual’s specific condition. By doing so, individuals can receive personalized advice and interventions, tailored to the unique aspects of their kyphosis, ensuring the best possible outcomes.
Adult Kyphosis Causes
The causes of adult kyphosis are divided into two categories:
- Degenerative kyphosis: This is the most common type of adult kyphosis. It is caused by wear and tear on the spine, which can lead to a loss of flexibility and strength in the spine.
- Idiopathic kyphosis: This type of adult kyphosis has no known cause. It is thought to be caused by a combination of factors, including genetics, muscle weakness, and poor posture.
The following lists some of the causes of this condition:
- The cause of an abnormal spinal curve can be linked to congenital reasons, which means the condition begins at birth. Also called congenital kyphosis, this condition affects the development of the spine as a person grows.
- The deformity can also stem from a traumatic event, called Post Traumatic Kyphosis, which means trauma or injury to the spine caused the problem.
- Iatrogenic factors derive from the effects of medical treatment or surgery.
- Postural Kyphosis is one of the most common conditions, usually caused by “slouching.” Exercising with posture improvement can improve and reverse this condition.Unlike structural spinal conditions caused by abnormalities within the spine itself, postural kyphosis is primarily due to chronic poor posture. This means it is not only highly treatable but also reversible.
Why It’s Reversible
The good news is that postural kyphosis can be corrected relatively easily. For instance, if you lay flat on the floor and actively attempt to straighten your spine so that it makes full contact with the floor, you’ll notice the abnormal kyphosis improving.
Steps to Correct Postural Kyphosis
- Posture Exercises: Incorporate exercises that focus on improving your posture.
- Movement Patterns: Address and correct bad postural and movement patterns that have led to the development of the condition.
By committing to these changes, you can see significant improvements and even reverse postural kyphosis.
As postural kyphosis is not structural, it is highly treatable and can be reversed by addressing the bad postural and movement patterns that led to its development. Treatment often includes practicing good posture and utilizing condition-specific physical therapy exercises. These exercises encourage spinal extension and increase core strength, so the muscles surrounding the spine can optimally support and stabilize it. By focusing on these targeted treatments, you can effectively manage and even reverse postural kyphosis. Osteoporosis causes a good number of kyphosis cases in adults. Osteoporosis leads to major losses of bone mass, leaving the bones brittle and prone to fractures.
Additionally, other factors contributing to kyphosis include:
- Congenital factors: Conditions present from birth that affect the development of the spine.
- Traumatic injuries: Damage to the spine resulting from accidents or physical trauma.
- Iatrogenic factors: These arise from the effects of medical treatments or surgeries.
- Osteoporosis: A condition that leads to significant bone mass loss, making bones brittle and prone to fractures. Osteoporosis is notably the most common cause of kyphosis in adults.
What is Forward Head Posture and How is it Related to Kyphosis?
Forward head posture (FHP) occurs when the head is positioned ahead of its neutral alignment over the spine. Imagine someone sitting at a desk and looking down at their phone. Often, the phone is not held at eye level, causing the neck to extend forward and downward. This unnatural angle places excessive stress on the cervical spine, increasing the effective weight of the head and leading to strain on the upper back and neck muscles.
Kyphosis, on the other hand, is characterized by an excessive outward curvature of the thoracic spine, resulting in a hunched back. Although commonly associated with older adults, it can affect individuals of any age.
The Connection Between FHP and Kyphosis
- Muscle Imbalance: FHP contributes to muscle imbalances, particularly tightening the muscles at the back of the neck and weakening the muscles in the front. Over time, this imbalance can cause the upper spine to curve more than usual, aligning with kyphotic posture.
- Increased Thoracic Strain: The forward tilt of the head exacerbates the upper thoracic spine’s natural curve. This extra strain can lead to a more pronounced kyphotic curve, changing the spine’s overall alignment.
- Chronic Pain: Both conditions can lead to chronic pain and reduced mobility. The combined stress from FHP and kyphosis can make it challenging to maintain good posture, exacerbating symptoms and potentially leading to further complications.
By understanding the interplay between forward head posture and kyphosis, individuals can take steps to correct their posture and reduce the risk of developing or worsening these conditions. Practicing good ergonomics and engaging in exercises designed to strengthen neck and back muscles can be beneficial strategies.
Symptoms of Adult Kyphosis
A patient’s symptoms can range from cosmetic, unattractive posture to pain, to severe pain and problems of pressure on the lungs and abdomen, based on the type of kyphosis and other underlying medical conditions of the patient. The pain occurs primarily in the area of the spine where the condition occurs. A severe curve can also begin to put pressure on the spinal cord and spinal nerve roots, which may cause weakness in the lower extremities. Eventually, pressure on the lungs and abdomen can affect breathing and appetite.
The symptoms of adult kyphosis can vary depending on the severity of the condition. Some of the most common symptoms include:
- A hunchback
- Back pain
- Neck pain
- Fatigue
- Shortness of breath
- Headaches
- Difficulty sleeping
- Depression
- Anxiety
Adult Kyphosis displays varying symptoms and degrees of severity, from minor changes in the shape of your back to severe deformity, nerve problems, and chronic pain.
Kyphosis can cause pain primarily in the area of the curvature. If the curve is severe, it can begin to put pressure on the spinal cord, leading to nerve compression. This compression can result in weakness in the lower extremities, further complicating mobility and daily activities.
If the kyphosis is situated in the thoracic spine, the curve can affect lung and heart function, making it difficult to breathe and potentially impacting cardiovascular health. These complications underscore the importance of early diagnosis and management to prevent the condition from progressing to such critical stages.
Adult Kyphosis Diagnosis
In order to make a proper diagnosis and rule out other possible conditions, the patient will provide his or her health history. To do this, your doctor will want to investigate the following specific items:
- Family History – Some types of kyphosis tend to run in families, so genetics could link to the deformity cause. Your doctor will want to know about other family members with kyphosis.
- Date of Onset – When did you first notice the appearance of the spinal condition?
- Measured Curve Progression – If previous X-rays exist, the doctor will want to compare old ones with new ones — measuring the size of the curve, or measuring changes in your height.
- The Presence or Absence of Pain – Not all cases of kyphosis produce pain. If pain exists, your doctor needs to know where, what brings it on or intensifies it, and if any radicular pain radiates away from the spine. This usually comes from irritation of the nerves as they leave the spine.
- Bowel or Bladder Dysfunction – Knowing when to urinate or make a bowel movement? This could signal the presence of pressure on the spinal cord or the nerves that go to the pelvis.
- Motor Function – Changes in how your muscles work? The condition may be linked to pressure on the nerves or spinal cord.
- Previous Surgery – If you previously experienced any surgery on your spine, kyphosis could occur due to weakened muscles or other problems. To properly evaluate your condition, your physician needs to know of any previous spinal surgery.
Additional Tests
After the initial examination and history, your doctor may order additional tests to get a clearer picture of your spine’s condition. These tests often include:
- X-rays – These allow the provider to see the structure of the spine and measure the curve. During the X-rays, you will be asked to hold certain positions while standing or lying on a table. You’ll need to stay very still while pictures are taken. Common X-ray views include:
- Front View: X-rays of the entire spine taken from the front.
- Lateral View: X-rays of the entire spine taken from the side.
- Lateral Bend: X-rays taken while you are bending sideways.
- Traction Films: These are taken when your spine is pulled and held in a particular position. These films are taken occasionally.
- MRI Scan – This scan is used to look at the nerves and spinal cord in detail.
- CAT Scan – This test provides a better picture of the vertebral bones, offering more detail than X-rays.
- Special Nerve Tests – These are conducted to determine if any nerves are being irritated or pinched.
Depending on the outcome of your history, physical examination, and initial X-rays, these additional tests can provide crucial information. They help in forming a comprehensive understanding of your condition, ensuring you receive the most accurate diagnosis and effective treatment plan.
Physical Exam
You will then undertake a physical exam. Your doctor will want to get an understanding of the curve in your back and how it affects you. This means first trying to get a “mental picture” of the spine’s curvature by examining your back and watching you move. The doctor will look at the flexibility you have by asking you to bend in certain directions.
During the exam, the provider will try to understand how the curve in your back is impacting your daily life. They will observe your posture and gait to see how you move and stand. Your doctor will also look at the flexibility you have when bending in certain directions.
Your doctor will generally look for abnormalities in the following areas:
- Spine Movement: Pain when you twist, bend, or move? If so, where? Have you lost flexibility?
- Strength: The strength of your muscles will get tested. The doctor may ask you to push or lift your arm, hand, or leg against resistance.
- Pain: The doctor may try to determine tenderness in certain areas.
- Sensation: Can you feel certain sensations in specific areas of your feet or hands?
- Reflexes: Your tendon reflexes might get tested, such as below the kneecap and in the Achilles tendon behind your ankle.
- Motor Skills: The doctor may ask that you walk on your heels or toes.
- Special Signs: Your doctor will also check for any indicators of something other than spinal/vertebrae problems. Some signs of other problems include tenderness in certain areas, a fever, an abnormal pulse, chronic steroid use (which leads to loss of bone mass), or rapid weight loss.
Finally, your nerves will be tested by checking your sensation, your reflexes, and the strength of your muscles. This comprehensive examination helps your doctor get a clear understanding of the extent of the curvature and its effects on your body, allowing for a more accurate diagnosis and tailored treatment plan.
What is a Kyphotic Curve?
A kyphotic curve refers to the natural curvature found in the thoracic region of the spine, which is located in the chest area. This curve resembles the letter “C,” with the open part of the “C” facing forward.
Key Points about the Kyphotic Curve:
- Normal Degree: Typically, this curvature ranges from 20 to 45 degrees.
- Function: The rounded shape helps distribute mechanical stress during movement and supports the spine’s structural integrity.
When is it Abnormal?
- A kyphotic curve exceeding 45 degrees is often considered abnormal and might be classified as a spinal deformity.
- Such excessive curvature can lead to various health issues, including pain and posture problems.
Understanding the kyphotic curve’s normal range is crucial for identifying and addressing potential spinal conditions.
Diagnostic Tests
Usually, after the physical exam, the doctor will order X-rays to see the structure of the spine and measure the curve. You will be asked to hold very still in certain positions while standing or lying on a table. If thoracic kyphosis potentially exists, the doctor will order the following images:
- Front view of the entire spine taken from the front
- Lateral view of the entire spine taken from the side
- Extension view of the spine while you bend backward
Depending on the outcome of your history, physical exam, and initial X-rays, other tests may be ordered to look at specific aspects of the spine. The most common tests are an MRI scan to look at the nerves and spinal cord, a CT scan to get a better picture of the vertebral bones, and special nerve tests to determine irritated or pinched nerves.
How Can Bad Postural and Movement Habits Be Corrected to Treat Postural Kyphosis?
Correcting bad postural and movement habits to treat postural kyphosis involves several key steps. This guide will help you understand the process and offer actionable solutions.
Adopt Good Postural Practices
- Exercise Regularly: Engage in physical activities that promote spinal extension and core strengthening. Pilates, for instance, offers exercises tailored to enhance posture.
- Ergonomic Adjustments: Modify your workspace—adjust your chair, computer monitor, and desk to promote better posture.
Specialized Physical Therapy
- Condition-Specific Exercises: Follow a regimen of exercises designed to target kyphosis. Programs like the ones from TheraBand include resistance training to support spinal alignment.
- Professional Guidance: Work with a physical therapist who can customize exercises based on your specific needs. Therapists can provide hands-on techniques to improve spinal curvature and build core strength.
Consistent Posture Monitoring
- Wearable Tech: Utilize posture-correcting devices from companies like Upright Go, which gently buzz to remind you to straighten up.
- Self-Check Practices: Periodically check your posture throughout the day. Ensure your back is straight, shoulders are back, and your head is aligned with your spine.
Correcting bad postural and movement habits to treat postural kyphosis is achievable with dedication and the right tools. Incorporate these strategies into your daily routine for effective results.
Treating kyphosis when it arises from structural problems within the spinal cord presents unique challenges. Here are the key limitations to be aware of:
- Limited Reversibility: Structural issues often involve abnormalities within the spinal cord itself, which can be inherently difficult to reverse completely. Unlike kyphosis caused by poor posture or weak muscles, structural deformities may resist full correction.
- Dependency on Early Diagnosis: Effective management is heavily reliant on early diagnosis. The earlier the condition is identified, the more options available for treatment, potentially reducing progression and complications.
- Complexity of Interventions: Treatment approaches for structural kyphosis can be more complex and invasive. Surgical interventions might be necessary, involving greater risks and longer recovery times.
- Variable Outcomes: The success of treatment can vary significantly from one individual to another. Factors such as the degree of curvature, overall health, and specific structural anomalies all play a role in determining outcomes.
- Ongoing Management: Even with successful interventions, patients often require ongoing management, including physical therapy and regular follow-ups, to maintain spinal health and monitor for potential deterioration.
In summary, while treating kyphosis caused by structural spinal issues can be more challenging, early detection and comprehensive care are crucial for achieving the best possible outcomes.
Idiopathic Kyphosis
Kyphosis can occur at any age, but when the cause is unknown, doctors typically refer to it as idiopathic. Idiopathic kyphosis most commonly affects adolescents and doctors refer to it as adolescent idiopathic kyphosis (AIK). For adolescents, this condition usually develops during the growth spurt that occurs during puberty and can progress gradually over time. AIK affects more girls than boys.
Although the exact cause of idiopathic kyphosis remains unclear, scientists believe it involves a combination of genetic, environmental, and postural factors. Scientists believe that certain genes may play a role in the development of this abnormal spinal curvature. Additionally, poor posture, muscle imbalances, and structural abnormalities of the spine may contribute to the progression of the condition.
In mild cases, idiopathic kyphosis may not cause significant symptoms or functional limitations. However, in more severe cases, it can lead to back pain, stiffness, fatigue, and a visible rounding of the upper back. If left untreated, severe kyphosis can potentially cause breathing difficulties and compression of internal organs.
Treatment for idiopathic kyphosis depends on the severity of the curvature and the age of the individual. Doctors can manage mild cases with physical therapy, exercises to strengthen the back muscles and postural training. In more severe cases, bracing may help correct the curvature and prevent further progression. Doctors consider surgery for severe or progressive cases that do not respond to conservative measures, particularly if a risk of neurological complications or significant functional impairment exists.
How Does Degenerative Kyphosis Develop?
Degenerative kyphosis often develops as a result of the wear and tear on the lumbar spine, the lower portion of your back. Over time, this degeneration can lead to several significant changes within the spinal structure:
- Collapse of Intervertebral Discs: The soft discs that act as cushions between vertebrae can weaken and collapse, reducing their ability to absorb shock.
- Altered Vertebrae Shape: The bones in your spine may change shape due to the ongoing pressure and stress they endure.
- Weakened Ligaments: The ligaments that support your spine can lose strength, which further destabilizes the spine.
As these factors contribute to a misalignment, the spine gradually curves into a kyphotic shape. This misalignment then exacerbates the degeneration, perpetuating a cycle of increasing wear and tear. Over the years, this process has led to a more pronounced and problematic kyphosis.
Understanding Congenital Kyphosis
Congenital kyphosis is a spinal condition that one is born with, resulting from irregular development of the spine. It often includes defects such as incomplete spinal formation, leading to pronounced forward curvature of the spine.
Key Features:
- Paralysis Risk: Congenital kyphosis is a leading non-traumatic cause of paraplegia, which affects movement in the lower body.
- Associated Abnormalities: Around 20-30% of individuals with this condition also have developmental issues in the urinary system.
- Diagnostic Tests:
- IVP (Intravenous Pyelogram): X-ray for examining kidney health.
- Myelogram & MRI: Ensure proper spinal development and detect abnormalities.
Treatment Options:
Surgery:
- Best suited for severe cases.
- Early intervention can halt the progression of spinal curvature.
Non-Surgical Methods:
- Less effective for correction.
- Requires vigilant observation and regular medical checkups to avoid complications.
In conclusion, congenital kyphosis is a serious congenital spinal defect with significant health implications, often necessitating surgical intervention for optimal outcomes.
Understanding Postural Kyphosis
Postural kyphosis, often referred to as “round back,” arises primarily from poor posture habits. This condition is predominantly seen in adolescents and young adults, who frequently slouch both when sitting and standing, leading to an exaggerated forward curve in the upper spine.
Key Characteristics:
- Prevalence: Most common among teenagers and young adults.
- Cause: Primarily due to habitual poor posture.
- Additional Factors: Often associated with “hyperlordosis” in the lower back. While the lumbar spine naturally curves inward (forming a “C” shape), hyperlordosis occurs when this curve becomes more pronounced as compensation for the excessive curvature in the upper spine.
Diagnosing and Identifying Postural Kyphosis:
- Self-Correction: The curve typically straightens when lying flat or when the spine is hyper-extended.
- X-rays: Diagnostic imaging won’t show vertebral abnormalities since this condition isn’t caused by structural deformities or damage.
Treatment and Management:
- Education: Learning and practicing proper posture can significantly alleviate the issue.
- Retraining: Guidance on how to sit and stand correctly helps in rectifying the posture.
- Muscle Strengthening: Exercises aimed at strengthening the back muscles can support better posture and reduce curvature.
Interestingly, treatment for postural kyphosis doesn’t necessitate the use of braces, casts, or intense exercise regimens. Simple lifestyle adjustments and an emphasis on maintaining a good posture are often enough to correct the condition.
Understanding the Causes of Scheuermann’s Kyphosis
Scheuermann’s kyphosis primarily affects the thoracic spine, leading to a pronounced curvature between 45 and 75 degrees. This condition is characterized by vertebral wedging, where three or more adjacent vertebrae take on a triangular shape, reducing the normal intervertebral space.
Key Features of Scheuermann’s Disease
- Vertebral Wedging: The misalignment and irregular shape of the vertebrae cause the spine to curve abnormally.
- Schmorl’s Nodes: Small herniations of the intervertebral discs into the vertebrae’s endplates.
- Thickened Ligaments: The anterior longitudinal ligaments often thicken and tighten, exacerbating the spinal deformity.
Theories Behind the Development
The exact cause of Scheuermann’s kyphosis is still unknown, but several theories offer insights:
- Vascular Issues: The disease’s namesake, Danish radiologist Scheuermann, suggested that avascular necrosis of the vertebral cartilage ring was to blame. This condition, caused by a lack of blood supply, leads to the death of cartilage and disrupted bone growth during development.
- Growth Plate Damage: Most researchers believe the process begins with damage to the vertebrae’s growth areas. This triggers abnormal growth patterns, resulting in excessive curvature. Rapid growth spurts during adolescence might exacerbate this damage.
- Spinal Mechanics: Some spine specialists propose that mechanical flaws in how the spine is constructed and functions could contribute to the condition. This could include issues with spine stability or alignment.
- Genetic Factors: There appears to be a significant genetic component, as the condition often runs in families. This suggests that inherited traits may play a crucial role.
- Other Potential Causes:
- Mild Osteoporosis: Reduced bone density may weaken the vertebrae and contribute to deformities.
- Muscle Abnormalities: Issues with the muscles supporting the spine might also play a part.
Each theory helps paint a broader picture of Scheuermann’s kyphosis, though the exact combination of factors varies between individuals. These insights are crucial for developing effective treatments and understanding this complex condition more deeply.
Adult Kyphosis Treatment Options
Originally, body casts were used to treat adult kyphosis and later turned into surgery.
Today, we prioritize conservative treatments whenever possible. These commonly include medications, exercise, physical therapy, and certain types of braces to support the spine. Furthermore, spinal surgery will generally occur as the last treatment choice due to the risks involved.
Factors Influencing Treatability and Reversibility of Kyphosis
Patient/Condition Characteristics:
- Patient Age: Age is a significant factor in determining treatment outcomes.
- Condition Type: It’s crucial to differentiate between postural and structural kyphosis, as these types respond differently to treatment.
- Condition Severity: The severity of the condition greatly influences treatability.
- Curvature Flexibility: The flexibility of the spinal curvature also plays a role in how treatable the condition is.
Postural Kyphosis
In cases of postural kyphosis, they are not only highly treatable but can also be completely reversed if the bad postural and movement habits that caused its development are remedied. This commonly involves:
- Correcting bad posture habits
- Integrating spinal-extension and core-strengthening exercises into a routine
Structural Kyphosis
When it comes to structural kyphosis, such as Scheuermann’s, the condition is structural and can be far more complex to treat. Treatment success will depend on:
- Condition severity
- Patient age
- Curvature flexibility
Osteoporosis and Degenerative Kyphosis
If osteoporosis exists, treatment of the condition may also slow the progression of degenerative kyphosis. This can be accomplished in several ways. Current recommendations include:
- Increasing calcium and vitamin D intake
- Weight-bearing exercises
Medications specifically for osteoporosis may be prescribed by your specialist. The use of a spinal brace may provide some pain relief. However, in adults, it will not cause the spine to straighten. Once you have reached skeletal maturity, bracing becomes a pain relief tool rather than a preventive tool.
While these treatments can help alleviate discomfort and prevent further progression of the kyphotic curve, it’s essential to consult with a doctor for personalized guidance. Understanding what kyphosis is and exploring the available treatment options will give you a more comprehensive approach to managing this condition.
A doctor can help you assess whether a back brace is an appropriate part of your treatment plan, taking into account your specific circumstances and overall health.
How Can Physical Therapy Help Treat Adult Kyphosis?
Physical therapy is a cornerstone in the treatment of adult kyphosis, offering a non-invasive way to manage and alleviate symptoms. By tailoring a specific exercise regimen, physical therapists aim to relieve pain and prevent the condition from worsening. Therapy sessions may be scheduled two to three times each week for up to six weeks.
The following are the key physical therapy benefits for Kyphosis
Posture Correction
- Physical therapy focuses on teaching proper body mechanics to maintain an erect posture, counteracting the spinal curvature.
Pain Relief
- Through various non-jarring exercises like swimming, patients can experience significant pain reduction.
Increased Activity Levels
- Regular physical activity not only maintains but can also improve spinal flexibility and overall mobility.
Daily Stretching
- Incorporating stretching exercises into daily routines helps maintain muscle elasticity and reduces stiffness.
Typical Recommendations in Physical Therapy for Kyphosis
- Correct Body Mechanics: Learning and maintaining proper posture techniques to inhibit further curvature.
- Non-Jarring Exercises: Engaging in low-impact activities such as swimming.
- Active Lifestyle: Keeping up with high levels of physical activity to enhance overall health.
- Stretching Routines: Performing daily stretches to maintain flexibility and diminish discomfort.
The goals of physical therapy:
- learn correct posture and body movements to counteract the effects of kyphosis
- maintain appropriate activity levels
- maximize your range of motion and strength
- learn ways to manage your condition
In conclusion, adhering to a well-structured physical therapy plan not only provides immediate pain relief but also supports long-term spinal health, making it a vital component in managing kyphosis
Learn more about spinal rehabilitation.
Surgical Treatment
All Surgeries involve some significant risks. For this reason, surgery recommendations only occur when the expected benefits far outweigh the risks. Surgery will not be recommended for most cases of kyphosis but may be recommended in the following situations:
Pain
Pain is the most common reason for kyphosis surgery — especially when chronic discomfort keeps getting worse. Most cases of adult kyphosis surgeries occur to relieve severe pain. However, if the pain becomes manageable through conservative treatments, surgery will probably not be recommended.
Progression of Curve
Progression of the spine deformity provides another reason for considering surgery. If the curvature continues to worsen, surgery should occur to prevent the problems that come from the severe spinal deformity.
Cosmetic Curves
In most cases, we will not recommend surgery for the sake of appearance. However, in some cases, kyphosis causes physical deformity that becomes unbearable to the patient. In these cases, surgery becomes the only option for correcting the condition. Most cases of cosmetic surgery happen in young adults who have very noticeable curves.
Surgical Procedure
When Adult Kyphosis requires surgery, doctors possess many different procedures from which to choose. Each case of kyphosis requires a very specialized, well-planned approach for optimal results. Surgery solves the problems of pain and discomfort that occur in the spine condition, not just straightening the spine.
When is Surgery Recommended for Adult Kyphosis?
Surgery may be recommended in the following situations:
- Pain: The most common reason for surgery is pain relief for increasing, chronic discomfort. Most cases of adult kyphosis surgeries are done to relieve severe pain. However, if the pain is manageable in any conservative way, surgery will not usually be recommended.
- Progression of Curve: Progression of the kyphosis deformity is another reason for considering surgery. If the curvature continues to worsen, surgery may be suggested. Surgery is recommended in this situation to prevent the problems that come from severe kyphosis.
- Cosmetics: In most cases of kyphosis, surgery will not be recommended simply for the sake of appearances. However, in some cases, kyphosis causes physical deformity that is unbearable to the patient. In these cases, surgery is the only option for correcting the condition. Most cases of cosmetic kyphosis surgery are in young adults who have very noticeable curves.
Goals of Surgical Procedures
The goals of most surgical procedures for adult kyphosis include:
- Reduce the deformity (straighten the spine as much as possible)
- Stop the progression of the deformity and the symptoms
- Remove any pressure from the nerves and spinal cord
- Protect the nerves and spinal cord from further damage
Finally, to achieve these goals, your surgeon may suggest an operation on the back of the spine, the front of the spine, or both. The operation will straighten the spine and then fuse the vertebrae into one solid bone.
Potential Complications of Adult Kyphosis Surgery
When considering kyphosis surgery, it’s essential to be aware of the potential complications that may arise. While this type of surgery can be beneficial, some risks need to be thoroughly understood and discussed with your healthcare provider.
Common Complications
- Infection: Post-surgery infections can occur, potentially leading to further medical interventions or prolonged recovery times.
- Bleeding: Excessive bleeding during or after surgery might require additional treatments.
- Pain: Chronic or intense pain may persist even after the surgical procedure.
- Nerve Damage: Operating near the spine and spinal cord bears the risk of nerve damage, which could result in numbness, weakness, or even paralysis.
Serious Risks
- Impairment: There’s a possibility of enduring physical limitations, affecting mobility or daily function.
- Hardware Failure: Surgical hardware, such as rods or screws, can fail, necessitating further surgery.
- Spinal Fluid Leak: The surgery may cause a leak of spinal fluid, which can lead to severe headaches or other complications.
Long-term Complications
- Degeneration of Adjacent Segments: The segments of the spine next to the operated area may wear down faster, potentially leading to more surgeries.
- Failed Back Surgery Syndrome (FBSS): Some patients might experience worsening symptoms after surgery, a condition known as FBSS, requiring continuous management or additional procedures.
Importance of Consultation
It’s imperative to have a detailed discussion with your doctor about these risks. Only a medical professional familiar with your specific condition can provide a comprehensive overview of potential complications and help you make an informed decision.
Remember, the list provided above is not exhaustive. Always rely on your healthcare provider for personalized medical advice.
Understanding Hyperkyphosis: A Deeper Look
Hyperkyphosis, commonly known as “roundback,” is a condition where the spine curves excessively. Whereas a normal spine does indeed have a natural curve, hyperkyphosis involves a more pronounced curvature, which can lead to problems if not addressed.
How Does Hyperkyphosis Occur?
The spine is divided into several regions, and while hyperkyphosis can occur in any of them, it is most frequently seen in the thoracic or mid-back area. The condition can also manifest in the cervical spine (neck area) or the lumbar spine (lower back). When the curvature in one of these regions is significantly greater than the others, it disrupts the balance and alignment of the spine.
Symptoms and Effects
The abnormal curvature in hyperkyphosis can cause pain and physical deformity. Although ‘kyphosis’ technically describes the type of curve, the term ‘hyperkyphosis’ specifically refers to the excessive, pathological curvature that exceeds normal limits.
Understanding and addressing hyperkyphosis is crucial to maintaining spine health and preventing further complications such as discomfort and pronounced spinal deformities.
Why Choose Southwest Scoliosis and Spine Institute?
The Southwest Scoliosis and Spine Institute has offices in Dallas, Plano, and Frisco, Texas. The practice is led by a team of highly qualified, experienced orthopedic surgeons. Our doctors are recognized as leaders in diagnosing and treating conditions of the spine. Furthermore, the practice is well recognized for the scope of services it offers, as well as its surgeon’s medical expertise.
The orthopedic surgeons at The Southwest Scoliosis and Spine Institute are board-certified, having completed rigorous training at the finest medical institutions in the country. Additionally, they specialize in all aspects of spinal care for children, adolescents, adults, and seniors.
Each patient’s treatment program is tailored to the patient’s specific needs. Also, we continue to monitor patients with ongoing reevaluations and adjustments as the recovery progresses. Furthermore, the team offers the most advanced treatment, which combines the latest state if tge art technology. The surgeons prioritize minimally invasive techniques. However, when necessary the surgeons will use sophisticated surgery to treat their patients and get them back to normal without pain as soon as possible. For those suffering from the pain that is associated with Kyphosis, we invite you to call us and make an appointment. We can help!
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If you or a loved one suffers from spinal pain, you owe it to yourself to call Southwest Scoliosis and Spine Institute at 214-556-0555 to make an appointment.