Kyphosis is a condition of abnormal curvature of the spine that causes rounding of the upper back or a hunchback. The thoracic portion of the spine normally has a “C”-shaped curve, but excessive forward curve in the spine leads to kyphosis. In adults, kyphosis may develop as a result of degenerative diseases such as arthritis, disc degeneration, osteoporotic fractures, traumatic injuries and slippage of vertebral disc. Kyphosis most commonly affects the thoracic spine but can involve the cervical and lumbar portions too.
The symptoms of adult kyphosis may vary based on the severity, ranging from minor change in the shape or appearance of your back to more severe nerve problems and long-lasting back pain. There may be weakness in the legs because of the pressure exerted on the spinal cord and nerve from the spinal curvature. Difficulty in breathing may also develop as a result of pressure over the lungs.
Your doctor will take a brief history which includes family history, history of your present symptoms, past medical history (whether you have undergone spinal surgery in the past). Then, a careful physical examination is done to evaluate the spine movement, strength of the muscles and sensation in order to make a proper diagnosis and also rule out other similar conditions. Some diagnostic tests such as X-rays, MRI scan and CT scan will be done to see the structure of the spine and measure the curve. The MRI and CT scan helps in identifying nerve and spinal cord abnormalities.
Adult kyphosis has several treatment options ranging from the most conservative methods to surgical correction of the spine. Conservative treatment is most often the first choice and includes medications, exercises, casts and support braces to the spine.
In cases where osteoporosis is the cause of kyphosis, slowing the progression of osteoporosis is recommended with the intake of vitamin D and calcium supplements, hormone replacement therapy, and regular exercises.
Physical therapy exercises and rehabilitation program helps to control pain, improve strength, mobility as well as perform daily activities easily. You can expect relief from pain even though the kyphotic curve cannot be rectified with the help of exercises. Physical therapy sessions may be scheduled 2-3 times in a week and should be continued for up to six weeks.
Spinal surgery is considered as the last treatment option due to the risks and complications that may occur and is recommended if the benefits of the surgery outweigh the risks. The situations in which surgery for kyphosis may be considered include:
- Chronic severe pain
- Progression of the curvature to more severe form
- Cosmetic reasons
The goal of surgery is to straighten the spine and join the vertebrae to form a solid bone and thus reduce the deformity. Metal screws, plates or rods are used to hold the vertebrae in place during the fusion.