The Southwest Scoliosis and Spine Institute with offices in Dallas, Plano, and Frisco, Texas has often been referred to as North Texas’s premier practice for Kyphosis treatment, Scoliosis, and other complex spinal issues.
Dr. Hostin explains that his practice treats both children and adults. “We provide a continuum of care, and a commitment to take care of our patients throughout their life.”
In most cases, kyphosis causes few problems and does not require surgery. Some patients may need to use a back brace or do specific exercises to improve their kyphotic posture and strengthen their spine. However, in cases of extreme spinal curvature, individuals with kyphosis may experience pain or stiffness in the back and shoulder blades, numb and tingling extremities, and painful and difficult breathing due to the excessively curved spine that presses and obstructs the airways. Patients with this severe problem may require surgery to reduce their neck spine curve and improve their well-being.
They may also experience tenderness of the spine and extreme fatigue alongside persistent pain that sometimes defies medication. Balance problems and bladder incontinence are also a source of concern with kyphosis.
Types of Kyphosis:
- Developmental Kyphosis (postural or Scheuermann’s kyphosis) – This usually becomes classified as either postural or structural in origin. Both occur in children and young adults, but they may occur at any age.
- Congenital Kyphosis – This occurs when the spinal column fails to develop while in utero.
- Post-Traumatic Kyphosis – This occurs as the result of an accident, and occurs due to an injury to the spine. This condition commonly occurs in the mid-to-lower back area.
- Postural Kyphosis – This is the most common type that is found during childhood. This spinal defect happens more commonly in girls than in boys. It rarely becomes painful and does not normally lead to problems as an adult.
Testing for Postural 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 Y. 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 see 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, correction can occur with proper posture.
The Scoliosis and Spine Institute has the latest EOS X-ray machine. An EOS X-ray, also known as EOS imaging, is a type of 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 than traditional X-rays.
EOS X-ray technology is often used in the diagnosis and treatment of musculoskeletal conditions, such as kyphosis, scoliosis, fractures, and joint disorders. It has the advantage of providing a more accurate and detailed image of the patient’s bones and joints, while also using significantly less radiation than traditional X-ray machines, which is an important consideration for patient safety.
Structural kyphosis, also known as Scheuermann’s kyphosis, occurs when the spine develops abnormally, with the front sections of the vertebrae growing slower than the back sections. Instead of normal, rectangular vertebrae with ideal alignment, this spinal defect results in more triangular, wedge-shaped vertebrae that cause the spine to not align properly.
Scheuermann’s kyphosis usually develops during periods of rapid bone growth (typically between the ages of 12 and 15 in males or a few years earlier in females). The doctor will notice a sharp and angular curve that appears stiff and rigid. Unlike postural kyphosis, Scheuermann’s kyphosis does not respond to good posture and standing up straight.
Developmental Kyphosis Treatment
A periodic exam is typically recommended for:
- Postural kyphosis (rounded back straightens with proper posture)
- Curves less than 60° in patients who continue to grow
- Curves 60° – 80° in patients who finish growing
X-Rays and Exercise
Full-spine X-rays get taken every six months as the child grows using our advanced in-house imaging system that scans the entire spine in just seconds with a low dose of radiation.
With a severe curve (60° – 80°) and a patient who keeps growing, we recommend brace treatment with a tailored exercise program. Our doctors recommend that patients wear the brace for 20 hours a day until the spine meets the doctor’s goals.
During the last year of treatment prior to skeletal maturity, part-time brace wear (12-14 hours/day) may be proposed. Brace wear must continue for a minimum of 18 months in order to maintain a permanent correction of the defect.
At Southwest Scoliosis and Spine Institute, we consider surgery only when necessary. Our surgeons use the most advanced treatment options to ensure that patients can return to a normal daily routine as soon as possible.
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 get 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 suggest surgery from the front as well. Patients usually return to a normal daily routine within four to six months following surgery.
Spine osteotomy, a surgical procedure, cuts and removes a section of the spinal bone to allow for correction of spinal alignment. The Smith-Peterson Osteotomy, one of the most common procedures, involves removing sections of bone from the back of the spine, as well as the posterior ligament and facet joints. This causes the spine to lean more toward the back, correcting the kyphotic curve.
Upon early diagnosis, the majority of patients get treated without surgery and go on to lead active healthy lives. If the condition does not get early treated, 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 curve.
Age-related kyphosis usually occurs over time as a result of compressed or cracked vertebra, 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.
There are two surgical options, which involve reinforcing the damaged vertebrae with specially designed bone cement. 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.
While congenital kyphosis occurs in lots of patients, its growth will cause serious health problems. For instance, the bones may develop in an unusual shape, or several vertebrae may fuse together.
Unfortunately, casting and/or bracing does not appear effective for every patient with congenital kyphosis. Patients with this spinal problem often need surgical treatment at a young age to stop the growth of the curve.
Congenital Kyphosis 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.
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.
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 occurs after an injury such as a fall from a height, a motor vehicle accident, or a horseback riding fall. The impact of these kinds of injuries can lead to fractures and/or dislocation of the vertebrae, which can lead to a curve of the spine, especially if the treatment gets delayed.
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 that need an operation for traumatic kyphosis, spinal fusion and bone removal will restore proper alignment.
“Two of the most common conditions that we see associated with increased kyphosis are idiopathic – Scheuermann’s Kyphosis – in our adolescent patients. Adult patients can also develop increased kyphosis with age-related and degenerative changes.” – Richard Hostin, MD
If you or a loved one suffers from spinal pain, please call the Southwest Scoliosis and Spine Institute at 214-556-0555 to make an appointment.