What is Kyphosis?
Kyphosis (from the Greek ‘kyphos’ meaning ‘humpback’) is a deformity of the spine causing a curvature (bent posture)
The spine, seen laterally, presents three curves:
- At the cervical section there is a lordosis
- At the thoracic section there is a kyphosis
- At the lumbar section there is a lordosis
These curvatures constitute the normal state of the spine.
Every human being has a normal kyphosis of 20°-40°.
However, in certain cases, these curvatures may be more accentuated.
When the kyphosis of the thoracic section becomes excessive, in other words when it exceeds 50°, then it is deemed pathological.
It is a condition encountered from childhood to the third age.
Kyphosis can be provoked by a bad posture of the body, a fact observed mainly in people who do not exercise.
Types of kyphosis
It is due to the abnormal growth of the spine or part of a vertebra during pregnancy (6-8 weeks).
Congenital kyphosis worsens with growth
There are two basic types of congenital kyphosis.
Failure of formation: it worsens with growth and is visible at birth.
Failure of segmentation: two vertebras fail to separate properly and to form normal discs. It is often visible after the child is walking.
There are cases where congenital kyphosis can be a severe deformity and affect other organs.
Kyphosis in adolescents
Idiopathic kyphosis is encountered in children and adolescents. Its causes are not known.
Juvenile kyphosis, also known as Scheuermann’s disease, is the result of wedge-shaped vertebras. It is thought to be hereditary, a hump in the back is observed which becomes rigid with skeletal maturity.
This type of kyphosis mainly appears between 12-14 years, more frequently in boys than in girls.
Idiopathic kyphosis must be distinguished from postural kyphosis.
At the same age, the so-called ‘slouchy’ kyphosis or ‘postural kyphosis’, where there are no problems with the vertebras.
In girls, it is observed during breast growth, when, out of shyness, they change their posture, while boys adopt this posture as a trend.
The aesthetic deformity (slouching), will lead the adolescent to visit the orthopaedic while usually there is no back pain. Very often, it is also combined with scoliosis and is characterised as kyphoscoliosis.
Kyphosis in adults
In older persons, it has other causes, such as osteoporosis or rheumatic disease, arthritis, etc., and is very often accompanied by chronic back pain (dorsodynia). In most cases of kyphosis in adults, the problem exists since their adolescence.
Kyphosis due to trauma may be caused by compression fractures of the thoracic portion of the spine.
In younger ages, the pain is usually minimal with a very marked hump. On the contrary, in older people, in cases of kyphosis with very important alterations, pain can be great. The main symptoms are:
- Cervical syndrome
- Back pain
- Lumbago (lumbar pain)
The clinical image of kyphosis may appear with one or more of the following symptoms:
- There is a compensatory lordosis in the lumbar portion of the spine
- The shoulders fall forward
- The shoulder’s joint is internally rotated
- The shoulders are protruding
- The belly protrudes
- Probable pain in the back
- Difficulty to breathe
- Quick fatigue
- Probable muscular weakness
- Loss of height
How is kyphosis treated?
The diagnosis is effected by clinical examination performed by an orthopaedic, surgeon specialising in scoliosis, who will detect the kyphosis through clinical examination and x-rays in order to assess the curvature and its probable aetiology.
According to the extent of the problem, kyphosis may either be addressed by conservative means or by surgery. According to the conservative approach, the combined use of a special brace and Physiotherapeutic Scoliosis Specific Exercises- PSSE is recommended, in order to help the body reacquire a correct posture and to reduce the pain, if any.
As for scoliosis so in kyphosis, it is necessary to proceed with x-ray tests in order to follow up on the progress of kyphosis when a brace is fitted. Nowadays, part of these tests have been replaced by the Formetric 4D method, which does not use any radiation.
At the Scoliosis SLC centre, we are in a position to offer the power of this technology.