KYPHOSIS TREATMENT

 

 

Questions and Answers

Structural Kyphosis

Structural kyphosis, called Scheuermann’s kyphosis, starts when the spine forms the wrong way. The front part of the spine bones grows more slowly than the back. Instead of square bones that line up, the bones take on a wedge shape. This wedge shape stops the spine from lining up the right way.

Scheuermann’s kyphosis often starts when bones grow fast, most often from ages 12 to 15 in boys and a bit sooner in girls. The doctor will note a sharp, stiff bend in the neck or mid-back. Unlike postural kyphosis, Scheuermann’s does not ease with a good stance or by standing tall.

Unlike postural cases, Scheuermann’s shows key spine bone flaws. Some bones in the mid-back take on a trap-like shape, which marks this disease. This bone flaw makes the curve stiff and harsh. If the curve grows harsh, the doctor may urge surgery to fix the bend.

Untreated Kyphosis

Untreated kyphosis brings back pain and stiff shoulder blades. It may cause numb or weak arms and legs, and hard, sore breathing. The harsh curve squeezes the chest and blocks the airways. Some patients with this strong bend may need surgery to cut down the curve and improve their health.

They may also feel bone pain, great tiredness, and pain that drugs can’t calm. They may face stance loss and poor bladder hold, which adds more stress.

The way kyphosis grows worse depends on its cause. A patient with bone loss breaks (from weak bone disease) will see worse bends if the bone loss stays. But meds that build bone strength may slow or stop this growth.

In Scheuermann’s kyphosis, where the cause remains unknown, growth years set the pace. A 35-year-old with a 70-degree bend may see little change. But a 12-year-old with the same bend risks sharp growth since their bones still grow.

The rate of change shifts with each case. This is why check-ups with a back doctor or surgeon stay key. X-rays done now and then help both the patient and the doctor plan care or watch for change. This way, care stays one step ahead.

Diagnosing Kyphosis

The diagnostic process for kyphosis begins with a thorough patient history. This involves gathering detailed information about the patient’s symptoms, medical background, family history, lifestyle factors, and any potential causes of the spinal curvature.

Symptom Evaluation

The patient’s symptoms are a critical component of the diagnostic process. Kyphosis can present with a range of symptoms, depending on the severity and underlying cause of the condition.

Pain

Pain appears as a common symptom associated with kyphosis, particularly in adults. The patient may report localized pain in the mid-back, which can get worse with prolonged sitting, standing, or physical activity. In some cases, the pain may radiate to the shoulders, neck, or lower back.

Postural Changes

Patients often notice changes in their posture, such as a visible hump or rounding of the back. This may occur when accompanied by a forward head posture or rounded shoulders.

Fatigue and Weakness

Patients with kyphosis may experience fatigue or muscle weakness, particularly in the back muscles, which are strained by the abnormal curvature.

Respiratory and Digestive Issues

In severe cases, kyphosis can lead to respiratory difficulties due to the compression of the lungs, as well as digestive issues caused by the compression of abdominal organs.

Onset and Progression

Understanding the onset and progression of the kyphosis becomes crucial for identifying the underlying cause and guiding treatment. The patient should advise the doctor of his or her age when the neck curve first appeared, whether it got worse over time, and any factors that caused its progression.

Congenital vs. Acquired

Determining whether kyphosis is congenital (present at birth) or acquired (developed later in life) becomes essential for diagnosis. Congenital kyphosis often presents in infancy or early childhood, while acquired forms may develop due to degenerative diseases, trauma, or poor posture.

Rapid vs. Gradual Onset

A rapid onset of kyphosis may suggest a more serious underlying condition, such as a vertebral fracture or tumor, while a gradual onset appears more typical of postural kyphosis or degenerative conditions.

Medical History

The patient’s medical history provides valuable context for the diagnosis of kyphosis. Relevant aspects of the medical history include:

Previous Spinal Conditions or Surgeries

A history of spinal conditions, such as scoliosis, or previous spinal surgeries, may contribute to the development of kyphosis or complicate its management.

Chronic Diseases

Chronic diseases, such as osteoporosis or arthritis, can weaken the vertebrae and lead to kyphosis. Patients should advise the doctor about any diagnosed conditions that may affect bone health.

Trauma or Injury

A history of spinal trauma, such as a fall or car accident, can lead to vertebral fractures and the subsequent development of kyphosis.

Family History

A family history of kyphosis or other spinal conditions may indicate a genetic predisposition to the condition. This is particularly relevant in cases of congenital kyphosis or Scheuermann’s disease, a form of kyphosis that typically presents in adolescence.

Lifestyle Factors

Lifestyle factors, such as occupation, physical activity level, and posture habits, can contribute to the development or exacerbation of kyphosis. Patients should advise the doctor about their daily activities, including any repetitive motions or postures that may strain the spine.

Physical Examination

The physical examination is a critical step in diagnosing kyphosis. It involves a detailed assessment of the patient’s posture, spine, and musculoskeletal system.

Postural Assessment

The postural assessment involves evaluating the patient’s standing and sitting posture to identify any abnormalities in spinal alignment.

Sagittal Plane Analysis

The sagittal plane analysis focuses on the side view of the patient’s spine, where the kyphotic curve is most apparent. The examiner will observe the degree of forward curvature, the position of the head and shoulders, and the alignment of the pelvis.

Coronal Plane Analysis

The coronal plane analysis evaluates the patient’s spine from the front or back. While kyphosis primarily affects the sagittal plane, the examiner should also check for any lateral curvature (scoliosis) or asymmetry in the shoulders or hips.

Spine Palpation

Palpation of the spine is performed to assess the vertebrae, identify areas of tenderness, and detect any structural abnormalities.

Vertebral Tenderness

The examiner will palpate each vertebra to identify areas of tenderness, which may indicate underlying conditions such as fractures, infections, or tumors.

Step-Off Deformities

Step-off deformities, where one vertebra becomes displaced relative to another, and felt in cases of spondylolisthesis or fractures. These deformities can contribute to the kyphotic curvature.

Range of Motion (ROM) Testing

ROM testing evaluates the flexibility and mobility of the spine. The doctor will ask the patient to perform various movements, such as bending forward, backward, and to the sides, to assess the degree of spinal flexibility.

Thoracic Flexibility

Thoracic flexibility is particularly important in kyphosis. Reduced flexibility in the thoracic spine may indicate structural abnormalities or muscle tightness contributing to the curvature.

Lumbar and Cervical Mobility

The examiner will also assess the mobility of the lumbar and cervical spine, as these regions can compensate for the thoracic curvature, leading to additional strain and discomfort.

Neurological Examination

A doctor will conduct a neurological examination to assess for any nerve involvement, which may occur in more severe cases of kyphosis, particularly those involving spinal cord compression.

Sensory Testing

Sensory testing involves checking for any changes in sensation, such as numbness or tingling, in the extremities. This can help identify potential nerve compression or damage.

Motor Strength Testing

Motor strength testing assesses the strength of the muscles innervated by the spinal nerves. Weakness in specific muscle groups may indicate nerve root compression or spinal cord involvement.

Reflex Testing

Reflex testing helps assess the integrity of the spinal cord and peripheral nerves. Abnormal reflexes, such as hyperreflexia or hyporeflexia, may indicate neurological involvement in kyphosis.

Functional Assessment

The functional assessment evaluates the impact of kyphosis on the patient’s daily activities and overall quality of life.

Gait Analysis

Gait analysis involves observing the patient’s walking pattern to identify any abnormalities related to kyphosis, such as altered balance, shortened stride length, or compensatory movements.

Activity Limitations

The doctor will ask the patient about any difficulties performing daily activities, such as bending, lifting, or reaching.

Imaging Studies

Doctors will use Imaging studies to confirm the diagnosis of kyphosis, assessing the severity of the curvature, and identifying any underlying causes. Your doctor can use several imaging modalities, depending on the clinical presentation and the information needed.

X-Rays

X-rays are the primary imaging modality used in the diagnosis of kyphosis. They provide a detailed view of the bones and alignment of the spine.

Lateral X-Rays

Lateral X-rays are taken from the side of the patient and are the most informative view for assessing the degree of kyphosis. The Cobb angle, a measure of the curvature, is calculated from these images to determine the severity of the kyphosis.

• Mild Kyphosis: Cobb angle of 20-40 degrees.
• Moderate Kyphosis: Cobb angle of 40-60 degrees.
• Severe Kyphosis: Cobb angle greater than 60 degrees.

Anteroposterior (AP) X-Rays

AP X-rays provide a frontal view of the spine, allowing for the assessment of any lateral curvatures (scoliosis) or vertebral anomalies that may contribute to the kyphosis.

Flexion-Extension X-Rays

Flexion-extension X-rays are dynamic images taken while the patient bends forward and backward. These images help assess spinal stability and flexibility, particularly in cases where instability is suspected.

Magnetic Resonance Imaging (MRI)

MRI provides detailed images of the soft tissues, including the spinal cord, intervertebral discs, and nerves. It becomes particularly useful in assessing complications associated with kyphosis.

Spinal Cord Compression

An MRI can identify any compression of the spinal cord or nerve roots, which may occur in severe kyphosis. This becomes critical for planning treatment, particularly if surgical intervention may occur.

Disc Degeneration and Herniation

MRI can also detect degenerative changes in the intervertebral discs, such as disc herniation or degeneration, which may contribute to the kyphotic curvature.

Infections and Tumors

In cases where infection or tumors are suspected as the underlying cause of kyphosis, MRI is the imaging modality of choice, as it provides superior soft tissue contrast compared to X-rays.

Computed Tomography (CT) Scan

CT scans provide highly detailed images of the bony structures of the spine for assessing complex fractures, congenital anomalies, and spinal instability.

Congenital Anomalies

CT scans can identify congenital anomalies, such as vertebral malformations or fusion, that may contribute to kyphosis.

Fractures

In cases where vertebral fractures are suspected, particularly in the setting of trauma or osteoporosis, CT scans provide precise imaging of the fracture patterns and any associated spinal instability.

Bone Density Testing

Bone density testing, often performed using dual-energy X-ray absorptiometry (DEXA), assesses the bone health of patients with kyphosis, particularly in older adults who suffer from osteoporosis.

Osteoporosis Assessment

Osteoporosis is a common underlying cause of kyphosis in older adults, leading to vertebral compression fractures and subsequent spinal curvature. DEXA scans measure bone mineral density and help identify patients at risk for fractures.

Nuclear Medicine Imaging

In certain cases, your doctor may use nuclear medicine imaging, such as bone scans, to assess bone activity and identify conditions such as infections, tumors, or fractures that may contribute to kyphosis.

Differential Diagnosis

The differential diagnosis process involves distinguishing kyphosis from other conditions that may present with similar symptoms or spinal deformities.

Scoliosis

Scoliosis, a lateral curvature of the spine, can sometimes mimic kyphosis, particularly when it displays a rotational component. However, scoliosis primarily affects the coronal plane, while kyphosis affects the sagittal plane.

Lordosis

Lordosis refers to an exaggerated inward curvature of the lumbar spine, often leading to a swayback posture. While lordosis primarily affects the lower back, it can sometimes coexist with kyphosis, complicating the diagnosis.

Ankylosing Spondylitis

Ankylosing spondylitis refers to a form of inflammatory arthritis that primarily affects the spine, leading to stiffness, pain, and eventual fusion of the vertebrae. It can result in a stooped posture similar to kyphosis, but the underlying pathology differs.

Spinal Tumors

Spinal tumors can cause localized pain, neurological symptoms, and spinal deformities, including kyphosis. Imaging studies, particularly MRI, differentiate tumors from other causes of kyphosis.

Spinal Infections

Spinal infections, such as osteomyelitis or discitis, can lead to vertebral destruction and subsequent kyphotic deformity. These conditions often present with systemic symptoms, such as fever and elevated inflammatory markers, and require prompt diagnosis and treatment.

Conclusion

The diagnosis of kyphosis refers to a multifaceted process that involves a thorough patient history, comprehensive physical examination, and the use of advanced imaging techniques. Accurate diagnosis is essential for determining the underlying cause of the kyphosis and guiding appropriate treatment. Early recognition and intervention can significantly improve outcomes for patients with kyphosis, preventing further progression of the curvature and associated complications. As diagnostic techniques continue to evolve, clinicians will acquire better technology to diagnose kyphosis and develop individualized treatment plans for their patients.

Testing for Kyphosis

Mild postural kyphosis often goes unnoticed until a scoliosis screening at school, which then prompts a visit to the doctor.  In more severe cases, especially with adults, doctors can easily see the rounding of the upper back.

During an exam, one of our doctors, Richard Hostin, MD, Devesh Ramnath, MD, Ishaq Syed, MD, Shyam Kishan, MD, and Kathryn Wiesman, MD, will ask you or your child to bend forward with both feet together, knees straight, and arms hanging free. This test allows the doctor to see the abnormal forward curvature of the spine and any spinal problems.

The doctor may also ask you or your child to lie down to see if this straightens a spinal curve. Doctors may also order X-rays to see if changes in the vertebrae or any other bony problems exist. In patients with postural kyphosis who do not possess any defects, a correction can occur with proper posture.

The Southwest Scoliosis and Spine Institute possesses the latest EOS X-ray machine. An EOS X-ray provides medical imaging technology that uses low-dose X-rays to create highly detailed 3D images of bones, joints, and other structures in the human body. Unlike traditional X-ray machines, which produce 2D images, EOS X-ray uses a special digital scanner to take two simultaneous X-ray images of the patient from different angles. This allows for the creation of a 3D image that provides greater clarity and accuracy for diagnosing Kyphosis than traditional X-rays.

The EOS X-ray uses significantly less radiation than traditional X-ray machines, which is an important consideration for patient safety. If the doctor sees mild kyphosis in children or adults, he can schedule a full spine X-ray every six months with the low-dose in-house imaging system.

Kyphosis Symptoms

Kyphosis shows a clear symptom with an abnormal upper spine curvature. Also, this creates a hunched or rounded back look, and doctors label a hunchback as kyphosis. This deformity stems from various causes, and severe or worsening cases affect posture, appearance, and quality of life. In addition, people notice rounded shoulders or a tilted head, and they may feel persistent upper back stiffness or pain. In advanced cases, the curvature becomes visibly exaggerated, often called a “hunchback.” Finally, this disrupts daily tasks, confidence, lung function, and triggers neck pain, while the extent varies widely.

Mild Kyphosis

Mild kyphosis features a 20-40 degree curvature. Sometimes, doctors may miss it and blame poor posture.

Moderate to Severe Kyphosis

Moderate to severe kyphosis exceeds 40 degrees. In addition, it forms a visible hump on the back, seen from the side. Significantly, this deformity pushes the head forward and rounds the shoulders.

Back Pain

Pain strikes as a common kyphosis symptom, especially as the curvature grows:

• Localized Pain: Pain targets the abnormal curvature area, often the mid to upper back. Patients call it a dull ache or sharp pain.
• Muscle Fatigue and Strain: Surrounding muscles strain to support the curvature. This causes fatigue and discomfort.
• Radiating Pain: Severe cases send pain to the neck, shoulders, or lower back. Altered spine biomechanics drives this.

Stiffness and Reduced Mobility

Kyphosis patients often feel stiffness in the thoracic region. This limits motion range:

• Reduced Flexibility: Excessive curvature restricts spinal flexibility. It hinders bending forward or twisting.
• Difficulty Standing Upright: Severe kyphosis makes standing straight hard. The curvature forces a forward lean.

Breathing Difficulties

Severe kyphosis, especially over 70-80 degrees, affects respiratory function:

• Compression of the Lungs: The abnormal curvature shrinks the thoracic space. Also, this compresses the lungs and limits breathing.
• Shortness of Breath: Patients feel dyspnea during activity, and patients experience compromised lung function causes this.

Neurological Symptoms

Kyphosis leads to nerve compression, especially in severe cases or with other spinal issues:

• Radiculopathy: Compressed nerve roots cause radiculopathy, and this brings pain, numbness, tingling, or weakness in arms or legs.
• Myelopathy: In extreme cases, compressing the spinal cord can cause myelopathy. Symptoms include walking trouble, loss, and bladder issues.

Neuromuscular Fatigue

Altered spinal curvature strains the neuromuscular system:

• Chronic Muscle Fatigue: Back, neck, and shoulder muscles tire, making it harder to maintain posture.
• Coordination and Balance Issues: Severe kyphosis shifts the body’s center and raises fall risk and balance problems.

Psychological Symptoms

The visible kyphosis deformity impacts psychology:

• Self-esteem Issues: People struggle with body image, and low self-esteem hits hard, especially in adolescence.
• Social Withdrawal: The deformity’s visibility causes withdrawal and avoidance socially and in sports.

Depression and Anxiety

Chronic pain, limits, and body image fuel mental health issues:

• Depression: Ongoing pain and restrictions breed hopelessness.
• Anxiety: Fears of worsening curvature, disability, or stigma spark anxiety.

Symptoms of Kyphosis Cause

• Postural Kyphosis: This common form hits adolescents. Poor posture drives it, not structural issues. It causes mild back pain. The flexible curvature improves with good posture. It lacks neurological symptoms.
• Scheuermann’s Kyphosis: This severe form strikes adolescents. Structural vertebral changes fuel it. It brings intense back pain, worsening with activity. The rigid curvature progresses if untreated. Severe cases may compress nerves, causing symptoms.
• Congenital Kyphosis: Present at birth, it stems from spine malformations. The curvature progresses fast as the child grows. Structural issues trigger early nerve compression and symptoms. It often links to heart or kidney defects.
• Degenerative Kyphosis: Common in older adults, it is tied to age-related changes like osteoporosis. It causes chronic back pain. Height loss occurs from collapsing vertebrae. Nerve compression brings leg pain, numbness, or weakness. Osteoporosis raises fracture risk, worsening curvature.
• Nutritional and Metabolic Kyphosis: Deficiencies like rickets or osteomalacia cause this. Bone pain and tenderness emerge. Muscle weakness contributes to deformity. General fatigue reflects the condition’s health impact.

Kyphosis Non-Surgical Treatment

Physical Therapy for Kyphosis

Physical therapy forms a key part of non-surgical kyphosis treatment. It boosts posture, strengthens spine-supporting muscles, increases flexibility, and eases pain. Therapists tailor programs to your specific needs and kyphosis cause.

Postural Training

Postural training underpins kyphosis management, especially postural kyphosis. Poor posture habits, not structural issues, drive this type. The goal is to retrain muscles for a neutral spine alignment.

Postural Awareness

Therapists educate you on proper posture during daily tasks. These include sitting, standing, and lifting. Postural awareness exercises practice correct alignment. You use mirrors or visual cues to monitor posture.

Adjustments

You adjust your workplace, home, and routines to maintain posture. This includes tweaking desk height, chair support, and computer screen position. These changes encourage spinal alignment.

Strengthening Exercises

Strengthening exercises target the back, shoulder, and core muscles. These muscles play a vital role in supporting the spine and posture.

• Back Extensor Strengthening: Back extensors help straighten the spine. They counteract kyphosis curvature. Prone back extensions, deadlifts, and resistance band rows work well.
• Core Stability: A strong core supports the spine and lightens back muscle load. Planks, bridges, and abdominal exercises help avoid worsening curvature.
• Shoulder and Upper Back Strengthening: Shoulder and upper back muscles improve posture. They reduce kyphosis. Scapular retractions, shoulder blade squeezes, and reverse flies help.

Stretching and Flexibility Exercises

Stretching boosts flexibility in spine muscles and joints. This reduces kyphosis severity and relieves discomfort.

• Chest Stretching: Chest stretches target the pectoralis major and minor. They counter forward shoulder rounding in kyphosis. Wall stretches, doorway stretches, and foam roller techniques work.
• Hamstring and Hip Flexor Stretching: Tight hamstrings and hip flexors worsen pelvic tilt and kyphosis. Regular stretches improve pelvic alignment and reduce curvature.
• Thoracic Spine Mobility: Thoracic mobility aids kyphosis management. Thoracic extension exercises, like foam roller use or cat-cow stretches, increase spinal flexibility.

Balance and Coordination Training

Balance and coordination exercises enhance stability. They cut fall risk, especially in older adults with kyphosis.

• Balance Exercises: Standing on one leg, using a balance board, or doing Tai Chi boosts proprioception and stability.
• Functional Training: These exercises mimic daily tasks. Sit-to-stand, stair climbing, and reaching improve coordination and strength.

Manual Therapy

Manual therapy involves hands-on techniques from a therapist. It improves spinal alignment, reduces pain, and boosts mobility.

• Spinal Mobilization: Gentle spine movements increase joint mobility. These techniques ease kyphosis discomfort.
• Soft Tissue Mobilization: This targets muscles, tendons, and fascia around the spine. Massage, myofascial release, and trigger point therapy reduce tension.

Bracing

Bracing offers a non-surgical option for managing kyphosis. It works best during adolescence when the spine grows. Braces prevent curvature progression and enhance posture.  Doctors use bracing for Scheuermann’s kyphosis, a structural form in teens. They consider it for adults with progressive kyphosis or those unfit for surgery.

Types of Braces:

• Milwaukee Brace: This traditional full-torso brace runs from pelvis to skull. It uses metal uprights and a chin support to correct curvature. It halts severe kyphosis but feels uncomfortable. It may affect daily life and self-esteem.
• Thoracolumbosacral Orthosis (TLSO): This modern brace covers the thoracic and lumbar regions. It extends from the armpits to the hips and fits under clothes. It’s less intrusive and better tolerated. Customization fits your body and curvature. Success relies on wearing it most of the day.
• Kyphologic Brace: This dynamic brace targets Scheuermann’s kyphosis. Lightweight materials apply corrective forces. It reduces the kyphotic curve while allowing movement. It’s comfortable and boosts compliance. It suits mild cases but struggles with severe or rigid curves.

Bracing Protocols:

• Bracing Protocol: Success depends on following the protocol. You wear the brace 16 to 23 hours daily.
• Duration of Bracing: Doctors recommend bracing until skeletal maturity. This hits around 18-24 months for teens. They may stop earlier with significant improvement.
• Weaning Off the Brace: As growth ends or curvature stabilizes, you reduce the schedule. Weaning tests if the spine holds alignment without support.
• Compliance and Monitoring: Regular visits with an orthopedic specialist track progress. Your doctor takes periodic X-rays to assess bracing effectiveness.

Pain Management

Pain management forms a key non-surgical treatment for kyphosis. It helps adults with chronic pain from curvature.

Medications:

• Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Ibuprofen and naproxen reduce pain and inflammation. They work well for mild to moderate pain. They’re widely available with few short-term side effects. Long-term use risks gastrointestinal, kidney, and heart issues.
• Acetaminophen: This over-the-counter option suits kyphosis patients who avoid NSAIDs. It tolerates well and skips gastrointestinal side effects. It handles inflammation poorly and may fail to relieve severe pain.
• Muscle Relaxants: Cyclobenzaprine or methocarbamol eases muscle spasms or tension. Doctors prescribe them for kyphosis patients.

Kyphosis Surgical Treatment

The degree of curvature signals the need for surgery. Kyphosis with a Cobb angle over 70-80 degrees counts as severe. It often requires surgical correction. The curvature causes notable cosmetic deformity, pain, and functional limits. This pushes the need for surgery.

Intractable Pain

Patients with kyphosis face persistent, debilitating pain. This pain resists conservative treatments and may need surgery. Additionally, the pain stems from spinal instability, nerve compression, or severe muscle fatigue from the abnormal curvature.

Neurological Symptoms

Surgery becomes vital when kyphosis triggers neurological issues. These include radiculopathy, myelopathy, or cauda equina syndrome. Furthermore, spinal cord or nerve root compression causes pain, numbness, weakness, or loss of bowel and bladder control.

Progressive Deformity

Rapid kyphosis progression, despite conservative care, demands surgery. This halts further curvature growth. Progressive deformity worsens symptoms, boosts disability, and raises surgical risks if delayed.

Respiratory Compromise

Severe kyphosis shrinks the thoracic cavity volume. This restricts lung function and causes breathing issues. Surgery helps when curvature harms pulmonary function and conservative methods fail.

Cosmetic Concerns

Significant cosmetic deformity from kyphosis may lead patients to seek surgery. Cosmetic issues alone rarely justify surgery. They influence decisions when paired with other clinical factors.

Surgical Techniques

The choice of surgical technique hinges on the cause, curvature severity, patient health, and surgeon skill. Main approaches include posterior spinal fusion, anterior spinal fusion, and combined anterior-posterior fusion. Minimally invasive techniques have gained popularity lately.

Posterior Spinal Fusion

Posterior spinal fusion ranks as the top kyphosis surgery. It fuses affected vertebrae to stabilize the spine. This corrects the abnormal curvature.

• Pedicle Screw Instrumentation: Pedicle screws enter the vertebrae on both sides. Rods connect to these screws for support. Bone graft material goes between the vertebrae. This promotes growth and permanent fusion over time.
• Osteotomies: Severe kyphosis needs osteotomies (bone cutting) for correction.
  • Smith-Petersen Osteotomy: This removes a posterior spine wedge. It boosts lordosis and reduces kyphotic curve.
  • Pedicle Subtraction Osteotomy (PSO): This cuts a vertebral body wedge. It allows greater curvature correction.
  • Vertebral Column Resection (VCR): This removes one or more vertebrae. It rebuilds the spine for severe deformity fixes.

Anterior Spinal Fusion

Anterior spinal fusion accesses the spine from the front. It often uses the chest or abdomen. Doctors pair it with posterior fusion for severe or rigid kyphosis.

• Disc Removal and Bone Grafting: This removes intervertebral discs. Bone graft material replaces them. It promotes spine fusion and stability.
• Anterior Instrumentation: Plates and screws provide extra support. They maintain spine alignment during fusion.

Combined Anterior-Posterior Fusion

Severe, rigid, or complex kyphosis needs combined anterior-posterior fusion. This maximizes deformity correction and boosts spinal stability.

• Staged Procedures: This approach may run as one surgery or staged events. Anterior and posterior parts occur on different days. Staged plans suit patients with major comorbidities or complex corrections.

Minimally Invasive Techniques

Minimally invasive spinal surgery (MISS) cuts morbidity from open surgeries. It uses smaller incisions, less muscle cutting, and reduced blood loss.

• Percutaneous Pedicle Screw Placement: This places pedicle screws through small incisions. Fluoroscopic guidance minimizes tissue damage. It may ease postoperative pain and speed recovery.
• Approaches: Anterior fusion may use a thoracoscopic method. Small chest incisions and a camera with tools limit tissue disruption.

Advantages and Limitations

Minimally invasive techniques reduce postoperative pain. They shorten hospital stays and speed recovery. They don’t suit all patients, especially those with severe or complex deformities needing big corrections.

Spinal Fusion Using Intervertebral Cages to Treat Kyphosis

Surgical Procedure:

• Preparation: The patient is placed under general anesthesia. The surgeon makes an incision to access the spine.
• Removal of Damaged Disc: The damaged intervertebral disc is removed to prepare the space for the cage.
• Insertion of Cage: An intervertebral cage filled with bone graft material (either autograft, allograft, or synthetic) is inserted into the disc space. The cage helps to maintain disc height and alignment.
• Stabilization: Rods, screws, or other fixation devices are often used to stabilize the spine during the fusion process.
• Bone Fusion: Over time, the bone graft material promotes the growth of new bone, fusing the adjacent vertebrae.

Types of Cages:

• Metal Cages: Made from titanium or other alloys, offering strength and durability.
• PEEK Cages: Made from polyetheretherketone, a plastic-like material that is radiolucent, allowing for better post-operative imaging.
• Expandable Cages: These can be adjusted to fit the patient’s anatomy more precisely.

Recovery:

• Initial Hospital Stay: Typically lasts a few days, during which pain management and initial mobilization are prioritized.
• Physical Therapy: Essential for regaining strength and mobility.
• Follow-Up: Regular check-ups to monitor the fusion process and adjust any external support devices like braces.

If kyphosis becomes severe (greater than 80°) and causes frequent back pain, our doctors will recommend surgical treatment. Surgery can correct the defect without the need for bracing after surgery. Pedicle screws, hooks, or cables are placed, two per level, and connected with two rods. Thanks to our enhanced recovery times, hospital stays for spine fusions are shorter than most. While most surgeries occur from the back, your doctor may also suggest surgery from the front.

Patients usually return to a normal daily routine within four to six months following surgery. With increasingly sophisticated surgical techniques and instrumentation, surgical treatment for kyphosis has become easier to recover from than ever before.

Preoperative Considerations

A thorough preoperative evaluation is essential to assess the patient’s overall health, the severity of the kyphosis, and any associated conditions.

Imaging Studies

Imaging studies, including X-rays, MRI, and CT scans, are crucial for evaluating the extent of the spinal deformity, assessing spinal cord or nerve root compression, and planning the surgical approach.

Pulmonary Function Tests

In patients with severe kyphosis, particularly those with respiratory compromise, pulmonary function tests may be necessary to evaluate lung function and determine the risk of respiratory complications during and after surgery.

Neurological Assessment

A detailed neurological examination is essential to assess the presence of nerve compression or spinal cord involvement. This evaluation helps determine the urgency of surgery and guides the surgical approach.

Patient Education and Counseling

Patient education is a critical component of preoperative care. Patients and their families should be informed about the risks and benefits of surgery, the expected outcomes, and the recovery process.

Informed Consent

Obtaining informed consent involves explaining the surgical procedure, potential complications, and alternative treatment options. Patients should have a clear understanding of the goals of surgery and the possible outcomes.

Psychological Support

Given the potential impact of kyphosis surgery on body image and self-esteem, psychological support may be beneficial. Patients should be encouraged to discuss their concerns and expectations with their healthcare team.

Optimization of Health Status

Optimizing the patient’s health status before surgery is essential to reducing the risk of complications.

Management of Comorbidities

Chronic conditions such as diabetes, hypertension, or osteoporosis should be managed and stabilized before surgery. This may involve coordinating care with other healthcare providers.

Nutritional Support

Adequate nutrition is vital for wound healing and bone fusion. Patients may require nutritional support or supplementation, particularly if they have underlying conditions such as osteoporosis.

Intraoperative Considerations

Anesthesia and Positioning

Kyphosis surgery is typically performed under general anesthesia. Proper patient positioning on the operating table is crucial to minimizing pressure on the spine and facilitating surgical access.

Prone Position

For posterior spinal fusion, the patient is positioned prone (lying face down). Special padding and supports are used to protect the bony prominences and prevent pressure sores.

Supine Position

For anterior spinal fusion, the patient is positioned supine (lying face up). A rolled towel or bolster may be placed under the shoulders to elevate the chest and improve surgical access.

Intraoperative Monitoring

Intraoperative neuromonitoring is often used during kyphosis surgery to assess spinal cord and nerve root function in real time. This helps reduce the risk of neurological complications.

Somatosensory Evoked Potentials (SSEPs)

SSEPs monitor the sensory pathways of the spinal cord by measuring the electrical activity in response to stimuli. Changes in
The SSEP signals during surgery can indicate potential injury to the spinal cord or nerve roots, allowing the surgical team to make immediate adjustments.

Motor Evoked Potentials (MEPs)

MEPs monitor the motor pathways of the spinal cord by stimulating the brain and recording the resulting muscle activity. Like SSEPs, changes in MEP signals can indicate potential neurological injury, prompting intraoperative interventions to prevent permanent damage.

Electromyography (EMG)

EMG is used to monitor nerve root function by measuring electrical activity in the muscles. This can help detect nerve irritation or damage during the placement of screws or other instrumentation.

Blood Loss Management

Kyphosis surgery can involve significant blood loss due to the extensive nature of the procedure. Effective blood management strategies are crucial to minimize complications and improve outcomes.

Preoperative Blood Donation and Anemia Management

Patients may be encouraged to donate their blood before surgery for autologous transfusion if needed. Preoperative anemia should be corrected with iron supplementation, erythropoietin, or other appropriate therapies.

Intraoperative Blood Conservation Techniques

Techniques such as controlled hypotension, cell saver technology (which recycles the patient’s blood), and the use of antifibrinolytic agents like tranexamic acid can help reduce intraoperative blood loss.

Postoperative Blood Management

Postoperative blood loss can be managed with continued monitoring, the use of drains, and appropriate transfusion practices if necessary.

Care and Recovery After Surgery

Immediate Postoperative Care

The immediate postoperative period focuses on monitoring for complications, managing pain, and initiating early mobilization.

Pain Management

Effective pain management is critical for patient comfort and early mobilization. A multimodal approach, combining opioids, non-steroidal anti-inflammatory drugs (NSAIDs), muscle relaxants, and regional anesthesia techniques, may be used.

Monitoring for Complications

Patients are closely monitored for potential complications, including wound infections, neurological deficits, respiratory issues, and deep vein thrombosis (DVT). Overall, vital signs, neurological status, and incision sites are regularly assessed.

Rehabilitation

Rehabilitation is a crucial component of recovery after kyphosis surgery, helping patients regain mobility, strength, and function.

Physical Therapy

Physical therapy typically begins within the first few days after surgery and focuses on gentle exercises to improve mobility and prevent complications like pneumonia or DVT. As healing progresses, therapy will focus on strengthening the back and core muscles, improving posture, and gradually increasing activity levels.

Occupational Therapy

Occupational therapy may be introduced to help patients adapt to daily activities during recovery, particularly if the surgery has impacted their ability to perform tasks like dressing, bathing, or driving.

Long-Term Follow-Up

Long-term follow-up is essential to monitor the success of the surgery, assess for complications, and guide continued rehabilitation.

Imaging Studies

Postoperative imaging, including X-rays or CT scans, is typically performed to assess the stability of the fusion, the position of instrumentation, and the correction of the curvature.

Monitoring for Complications

Long-term complications such as hardware failure, pseudoarthrosis (non-union of the bone), or adjacent segment disease (degeneration of spinal segments above or below the fusion) are monitored during follow-up visits. Patient Education and Lifestyle Modifications

Patients are educated on lifestyle modifications to protect the spine, such as avoiding high-impact activities, maintaining a healthy weight, and practicing good posture. Then, continued participation in exercise and physical therapy may be recommended to maintain strength and flexibility.

Complications and Risks

While kyphosis surgery can be highly effective, it carries inherent risks and potential complications. Similarly, understanding these risks is crucial for patient education and informed consent.

Neurological Complications

Neurological complications, although rare, can occur during or after kyphosis surgery. These may include:

Spinal Cord Injury

Intraoperative damage to the spinal cord can result in permanent neurological deficits, including paralysis or loss of bowel and bladder function. The use of intraoperative neuromonitoring helps reduce this risk.

Nerve Root Injury

Injury to the spinal nerve roots during surgery can lead to radiculopathy, characterized by pain, numbness, or weakness in the limbs. This may be temporary or permanent, depending on the extent of the injury.

Mechanical Complications

Mechanical complications involve issues with the surgical hardware or fusion process:

Hardware Failure

Pedicle screws, rods, or other instrumentation may fail or loosen over time, potentially requiring revision surgery. Factors contributing to hardware failure include poor bone quality, excessive physical activity, or inadequate fusion.

Pseudoarthrosis

Pseudoarthrosis occurs when the bones fail to fuse as intended, leading to persistent pain and spinal instability. Basically, this complication may require additional surgery to achieve proper fusion.

Infection

Infection is a potential complication of any surgical procedure, including kyphosis surgery. To sum up, a patient’s Infections can range from superficial wound infections to deep infections involving the spinal hardware.

Superficial Infections

Superficial infections may present with redness, swelling, and drainage at the incision site. Therefore, these infections are typically treated with antibiotics and local wound care.

Deep Infections

Deep infections are more serious and may require surgical debridement, removal of the hardware, and prolonged antibiotic therapy. That said, surgeons are aware that deep infections can jeopardize the success of the fusion and may lead to additional surgeries.

Respiratory Complications

Respiratory complications are a particular concern in patients with kyphosis, especially those with pre-existing pulmonary issues or those undergoing anterior approaches.

Pneumonia

Reduced lung capacity and prolonged immobility after surgery increase the risk of pneumonia. Additionally, early mobilization, respiratory therapy, and incentive spirometry can help prevent this complication.

Atelectasis

Atelectasis, or the collapse of part of the lung, can occur due to shallow breathing or immobility. Notably, postoperative respiratory exercises and pain management are crucial in preventing this condition.

Vascular Complications

Vascular complications, although rare, can occur during spinal surgery, particularly during anterior approaches or osteotomies.

Major Vessel Injury

Injury to major blood vessels, such as the aorta or vena cava, can lead to significant blood loss and may require emergency vascular surgery. Preoperative imaging and careful surgical technique are essential to minimize this risk.

Deep Vein Thrombosis (DVT) and Pulmonary Embolism (PE)

The risk of DVT and PE is increased in patients undergoing spinal surgery due to immobility and the use of anesthesia. Prophylactic measures, including anticoagulants, compression devices, and early mobilization, are essential to reduce this risk.

Outcomes and Prognosis

Short-Term Outcomes

Short-term outcomes of kyphosis surgery typically involve relief from pain, improvement in spinal alignment, and enhanced quality of life. Most patients experience significant pain reduction and can resume normal activities within a few months of surgery.

Long-Term Outcomes

Long-term outcomes vary depending on the severity of the kyphosis, the success of the fusion, and the presence of any complications. Successful surgery can result in long-term pain relief, stable spinal alignment, and improved physical function.

Quality of Life

Many patients report an improvement in quality of life after kyphosis surgery, including better posture, increased physical activity levels, and enhanced self-esteem. However, outcomes may be less favorable in patients with pre-existing neurological deficits or significant comorbidities.

Functional Outcomes

Improved functional outcomes, such as increased mobility and reduced disability, are common following kyphosis surgery. Patients are often able to return to work, engage in recreational activities, and perform daily tasks with greater ease.

Factors Influencing Outcomes

Several factors can influence the outcomes of kyphosis surgery, including the patient’s age, the severity of the curvature, the presence of comorbidities, and adherence to postoperative rehabilitation.

Age

Younger patients generally have better outcomes due to greater bone healing capacity and fewer comorbidities. However, older patients with good overall health can also achieve favorable results with appropriate surgical planning and care.

Severity of Curvature

Patients with less severe curvatures may have better outcomes, as the surgery is less extensive and the risk of complications is lower. However, even patients with severe kyphosis can experience significant improvements with successful surgery.

Comorbidities

The presence of comorbid conditions, such as osteoporosis, diabetes, or cardiovascular disease, can impact surgical outcomes. Proper management of these conditions before and after surgery is crucial to improving prognosis.

Conclusion

Surgical treatment for kyphosis is a complex but often necessary intervention for patients with severe spinal deformity, intractable pain, or neurological symptoms. The decision to undergo surgery requires careful consideration of the patient’s symptoms, overall health, and the risks and benefits of the procedure. Advances in surgical techniques, instrumentation, and postoperative care have improved the outcomes of kyphosis surgery, allowing many patients to experience significant relief from symptoms and improved quality of life.

Despite the potential risks and complications, kyphosis surgery remains a highly effective treatment for many patients, particularly when conservative treatments have failed. Successful surgical outcomes depend on thorough preoperative planning, meticulous surgical technique, comprehensive postoperative care, and long-term follow-up. As our understanding of spinal deformities and surgical techniques continues to evolve, the prognosis for patients with kyphosis will likely continue to improve, offering hope for those affected by this challenging condition.

Hospitalization and Anesthesia

General anesthesia is used during these surgeries, and hospitalization typically lasts between four to six days, depending on the extent of the surgery and the patient’s age.

Physical Therapy

Physical therapy is generally started once the bones have had some time to heal, usually between three to six months post-surgery.

Success and Outcomes

In patients with good bone quality, excellent results can be achieved. Success is defined as a solid fusion that reduces pain and decreases the magnitude of the neck curve while maintaining a balanced spine. This comprehensive recovery plan ensures that patients are well-informed about what to expect throughout their healing journey.

Spinal fusion is a surgical technique used to join two or more vertebrae, eliminating motion between them. Intervertebral cages, also known as spinal cages, are devices inserted into the intervertebral space to help maintain the space and promote fusion.

Potential Risks and Complications

While spinal fusion with intervertebral cages can be highly effective, it carries several potential risks and complications, as with any major surgery.
Infection:

• Post-operative infections can occur at the incision site or deeper within the spine. Normally, antibiotics are administered to prevent and treat infections.

Bleeding:

• Significant blood loss may occur during surgery, sometimes necessitating a blood transfusion.

Nerve Damage:

• The closeness to spinal nerves means there’s a risk of nerve injury, potentially leading to pain, numbness, or weakness.

Non-Union (Pseudoarthrosis):

• In some cases, the bone graft does not fully fuse, leading to persistent instability and pain, possibly requiring additional surgery.

Implant Complications:

• Hardware failures, such as breakage or dislodgement of screws and rods, can occur, necessitating revision surgery.

Adjacent Segment Disease:

• Fusion can place additional stress on the vertebrae above and below the fusion site, potentially leading to degeneration of these segments over time.

Chronic Pain:

• Despite successful fusion, some patients may have ongoing pain, requiring further treatment.

Respiratory Complications:

• Given the thoracic involvement in kyphosis surgery, there is a risk of breathing issues, especially if the surgery is extensive.

Anesthetic Risks:

• General anesthesia carries risks such as allergic reactions, breathing problems, and heart problems.

Dural Tears:

• Accidental tears in the dura mater (the outer membrane of the spinal cord) can lead to spinal fluid leaks, which might cause headaches and other problems.

Conclusion

The list of complications provided here is not intended as a complete list of complications and is not a substitute for discussing the risks of surgery with your doctor. Furthermore, patients must be fully informed about what surgery entails, including both the potential benefits and risks.  All things considered, spinal fusion using intervertebral cages is a robust treatment option for severe kyphosis, offering the potential for significant improvement in spinal alignment and quality of life. However, patients and their medical teams need to weigh the benefits against the potential risks and complications to make informed decisions about undergoing this complex surgery.

Before proceeding with surgery, patients should consider the following:

• Risks of Serious Complications: Engage in a thorough discussion with your doctor about the risks specific to spine surgery. Subsequently, your orthopedic doctor will evaluate your condition and inform you of the risks of any medical treatment he or she may recommend.
• Long-Term Impact: Understand that while surgical interventions can provide relief, they come with their own set of challenges that may include long-term management of pain and mobility.
• Need for Further Interventions: Be aware that complications arising from the initial surgery could require subsequent interventions.

Long-Term Prognosis

Upon early diagnosis, the majority of patients get treated without surgery and go on to lead active, healthy lives. If the condition is not treated early, the growth of the curve could lead to problems in adulthood.

For patients with kyphosis, regular checkups are needed to monitor the condition and check for any growth of the neck curve.

Age-Related Kyphosis

Age-related kyphosis usually occurs over time as a result of compressed or cracked vertebrae, leading to an increased curve.

This spinal problem affects between 20 – 40% of older adults (mostly women) and usually results from several factors, including:

• Poor posture
• Increased stress on the spine
• Poor gait (which can lead to falls)

Age-Related Kyphosis Treatment

Exercise programs, spinal orthotics, and other treatments may help delay the growth of age-related kyphosis. In addition, research needs to learn which treatments provide the best choices for widespread clinical use.

Medicines provide bone-building for patients with age-related kyphosis and low bone density or spine fractures, often due to conditions such as osteoporosis. Fortunately, there are two surgical options, which involve reinforcing the damaged vertebrae with specially designed bone cement. Finally, these surgeries mainly help to relieve pain and increase the range of motion and mobility, and in some cases, surgery can reduce the spine angle as well.

Congenital Kyphosis Treatment

While congenital kyphosis occurs in many patients, its growth will cause serious health problems. For instance, the bones may develop in an unusual shape, or several vertebrae may fuse. Unfortunately, casting and/or bracing do not appear effective for every patient with congenital kyphosis. Nevertheless, patients with this spinal problem often need surgical treatment at a young age to stop the growth of the curve.

Non-operative Treatment

Our doctors strongly believe in watching our young patients with periodic X-rays to monitor curvature. Unfortunately, casting/bracing does not work for congenital kyphosis. While braces may delay growth, research does not provide evidence that this method of treatment will work 100% of the time.

Operative Treatment

After years of study and after hundreds of surgeries with very positive results on Congenital Kyphosis, our surgeons believe that the treatment of the spine should begin by fusing the deformed vertebrae.  In addition, the surgeon may recommend separate surgery approaches from the front and the back of the spine.

Prognosis

Should your child require surgery to correct kyphosis, the expert surgeons and caregivers at our practice can provide the care and attention they deserve. In addition, Drs. Richard Hostin, Kathryn Wiesman, and Shyam Kishan have been treating children and young adults for more than 10 years. Because the skeleton grows quite quickly in the first year of life, doctors do not usually find spinal cord compression.  However, when it does appear and continues to grow, doctors usually delay surgery until adolescence.

Post-Traumatic Kyphosis

Post-Traumatic Kyphosis strikes after injuries like a fall from a height, a motor vehicle accident, or a horseback riding fall. Then, these impacts cause fractures or dislocations of the vertebrae. This leads to a spine curve, especially if treatment delays occur. Traumatic kyphosis worsens if the injury heals without care.

Treatment options vary by factors like fracture type, spine curvature degree, and patient size. As a result, patients not needing surgery use bracing to support the spine. Therefore, bracing holds it in an ideal position as it heals. Basically, physical therapy eases pain, strengthens muscles, and improves posture. Overall, patients needing surgery undergo spinal fusion and bone removal. This restores proper alignment.

Other Causes of Kyphosis

Kyphosis also develops after spine trauma or spine surgery. Less common causes include skeletal dysplasias like achondroplasia, vertebral development issues, and neuromuscular disorders. After lumbar fusions for adult scoliosis correction, kyphosis emerges above the fusion. The stress between fused and non-fused spine parts creates this tough problem. Surgeons have not yet solved it fully.

In the cervical spine (neck), kyphosis occurs after cervical laminectomy. This surgery removes the posterior bony arch to decompress the spinal cord. Doctors call this “post-laminectomy kyphosis.” It was common before surgeons learned to prevent it with fusions. Today, post-laminectomy cervical kyphosis appears less often.

Post-Traumatic Kyphosis Treatment

Traumatic kyphosis can get even worse if the injury heals without treatment. Treatment options depend on many factors, including the type and size of the fracture, the degree of spine curvature, and the size of the patient. For patients who do not need an operation, treatment includes bracing to support the spine to keep it in a more ideal position as it heals, as well as physical therapy, which can help lessen pain, strengthen muscles, and improve posture. For patients who need an operation for traumatic kyphosis, spinal fusion, and bone removal will restore proper alignment.

Hyperkyphosis

Hyperkyphosis marks a medical condition with excessive forward spine curvature. This exceeds the usual curvature, often called “roundback.” Alternatively, it brings pain and noticeable physical deformity. Thus, a degree of curvature stays normal and healthy. Hyperkyphosis oversteps this, mainly hitting the thoracic mid-back region. Unfortunately, it also impacts the cervical (neck) and lumbar (lower back) areas. The term hyperkyphosis describes the curve itself. People often use it interchangeably with hyperkyphosis for the excessive curvature disorder.

The Link Between Osteoporosis and Kyphosis

The connection between osteoporosis and kyphosis primarily lies in the structural weakening of the spine caused by reduced bone density. When osteoporosis weakens the vertebrae, they are prone to compression fractures. These fractures more commonly occur in the front part of the vertebra, leading to its collapse. As a result, the spine starts to curve forward, producing the dowager’s hump, a common kyphosis manifestation in those with osteoporosis.

Preventing and Managing Osteoporosis and Kyphosis

Prevention plays a critical role in managing both osteoporosis and kyphosis. Regular screening for bone density appears vital, particularly for women approaching or undergoing menopause. Detecting osteoporosis early can significantly help in taking appropriate measures to strengthen the bones and prevent fractures.

• Screenings: It’s recommended for women, especially those perimenopausal, to undergo routine bone density tests, which can foresee the risk of osteoporosis.
• Specialist Care: For those already affected by or at high risk for osteoporosis, consulting with specialists in bone health becomes crucial. These professionals can provide targeted treatments and lifestyle strategies to maintain bone health.
• Healthy Practices: Engaging in regular exercise, particularly weight-bearing and strength-training exercises, can fortify bone health. Additionally, ensuring a diet rich in calcium and vitamin D can support bone density.

Understanding and addressing the nuances of kyphosis and osteoporosis with appropriate preventive measures and medical care can significantly reduce the risk of severe spinal deformities and improve quality of life.

Why Patients Choose Southwest Scoliosis and Spine Institute

Orthopedics refers to a specialty of our doctors and surgeons at the Southwest Scoliosis and Spine Institute. They understand your concerns, can answer your questions regarding your condition, and know how to use their specialized knowledge to assist you.  Richard Hostin, MD, Devesh Ramnath, MD, Ishaq Syed, MD, Shyam Kishan, MD, and Kathryn Wiesman, MD, have many years of training and experience in Spine and Back Pain for kids, adolescents, young adults, and seniors, and can help people of all ages get back to living the life they love.

The Facts

• Expertise in the spine: The team of specialists at Southwest Scoliosis and Spine Institute is recognized as the very best.  They specialize in the diagnosis and treatment of spinal conditions, ensuring the best possible care for their patients.
• Cutting-edge technology: Our practice uses the latest technology and techniques to diagnose and treat a wide range of conditions.  In addition, we use minimally invasive procedures that reduce pain and promote faster recovery.
• Comprehensive care: Our practice offers a full range of services, from diagnostic imaging and physical therapy to surgery.  Actually, we ensure that patients receive complete, seamless care for their spinal conditions.
• Dedicated facilities: The Southwest Scoliosis and Spine Institute provides patients with a safe and comfortable environment.

Finally, our board-certified physicians and fellowship-trained orthopedic surgeons use the full range of treatments to treat their spine patients. Southwest Scoliosis and Spine Institute’s experts with offices in Dallas, Plano, and Frisco, Texas, offer cutting-edge technology, comprehensive care, and dedicated facilities to ensure the best possible care for their patients. Get in touch with us today and schedule an appointment if you have a problem with Kyphosis.

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Citations:

 

NHS of Britain: Kyphosis

Spine-Health – For info on spinal fusion procedures.

MedlinePlus – For general info on spinal fusion.

Johns Hopkins Medicine – For an overview of spinal fusion and risks.