Kyphosis overview

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Kyphosis (Greek – kyphos, a hump), in general terms, is a curvature of the upper spine. It can be either the result of bad posture or a structural anomaly in the spine.

Many radiologists will detect kyphosis with a scolie or an AP-Lateral — two types of X-ray. A scolie is an X-ray taken from the rear. An AP-Lateral is taken from the side, where the X-ray machine is programmed to show the spine with high definition.

In the sense of a deformity, it is the pathological curving of the spine, where parts of the spinal column lose some or all of their lordotic profile. This causes a bowing of the back, seen as a slouching posture. Symptoms of kyphosis, that may be present or not, depending on the type and extent of the deformity, include mild back pain, fatigue, appearance of round back and breathing difficulties. Severe cases can cause great discomfort and even lead to death.

Kyphosis is classified into postural, Scheuermann’s, congenital, nutritional and gibbus variety.

Osteoporosis, disk degeneration like arthritis, ankylosing spondylitis are some of the risk factors which predispose to developing kyphosis.

Complications such as inflammation of the soft tissue or deep inflammatory processes, breathing impairments, bleeding, and nerve injuries may develop with longstanding kyphosis. The prognosis depends upon the underlying cause (worst, if caused by tumors) and whether the patient has developed any complications.

The common symptoms in a patient with kyphosis include appearance of hunchback, fatigue, back pain and shortness of breath.

The kyphotic deformity may be visible on gross inspection or may require Adam’s forward bending test for the rounded curve of kyphosis to appear.

MRI is used to show the abnormality of the spine and also to identify the cause of the kyphosis.

NSAIDs are used to relieve pain in kyphosis. Ca-D is recommended in old patients with osteoporosis. Antibiotics are used in case of infectious etiology and chemotherapy is used for tumors. Correct posture is recommended and braces like the Milwaukee brace is often used to treat kyphosis. In patients with progressive kyphotic deformity due to vertebral collapse, a procedure called a kyphoplasty may arrest the deformity and relieve the pain. Appropriate posture can help prevent postural variety of kyphosis.

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