Kyphosis

What is kyphosis?

Kyphosis is a progressive spinal disorder where the spine curves outward more than it should causing people to appear hunched. It is sometimes called hunchback. 


What causes kyphosis?

The spine is made up of bones that look like blocks, which are stacked one on top of each other in a column. Kyphosis happens when these spinal bones (vertebrae) become more wedge shaped. This can be due to fractures of the vertebrae, osteoporosis or disk degeneration. 

Kyphosis can also happen if your spine doesn’t develop properly before birth, and kyphosis in children is sometimes associated with certain medical conditions, such as Ehlers-Danlos syndrome.


What are the types of kyphosis?

The three most common types of kyphosis are postural kyphosis, Scheuermann’s kyphosis and congenital kyphosis.


What is postural kyphosis?

Postural kyphosis usually occurs during the teenage years. Poor posture stretches the ligaments and muscles holding the vertebrae in place. This in turn pulls the vertebrae out of their correct position, causing the spine to curve. Postural kyphosis does not usually cause pain or other issues. 


What is Scheuermann’s kyphosis?

Scheuermann’s kyphosis (named after the radiologist who identified the condition) happens when your vertebrae, instead of being cylinder or rectangle shaped, are wedge-shaped, causing the spine to curve forwards. This type of kyphosis usually begins during the growth spurt before puberty, and results in a rigid curve, which can be painful.


What is congenital kyphosis?

Congenital kyphosis occurs when your spine didn’t develop properly before you were born. It can worsen as you grow, and you usually need surgery at a young age to stop the curve from getting worse.


What are the symptoms of kyphosis?

The most obvious symptom of kyphosis is having rounded shoulders or a hump in your upper back. You may also experience tightness in your hamstrings (the three muscles in the back of your thighs).

People with severe kyphosis may also suffer from: 

  • Stiffness or pain in your back and shoulder blades
  • Weak, numb, tingling legs
  • Extreme tiredness
  • Breathing difficulties
  • Balance problems
  • Bladder incontinence or bowel incontinence

How is kyphosis diagnosed? 

Physical examination: you may be asked to bend over so your consultant can assess the curve of your spine. 

Spine X-ray: an X-ray of your spine is usually required to determine the extent of your spine’s curvature. The natural curve is between 20 and 45 degrees. 

Magnetic resonance imaging (MRI): an MRI may be recommended to check for an infection or tumour.

CT scan: a CT scan of the spine may be needed if your doctor wants more detailed images.


Will I need kyphosis surgery?

Treatment for kyphosis depends on your age, and the cause and extent of the curvature. If your symptoms are severe, and other treatments are inappropriate or ineffective, you may need surgery. 

The most common procedure is spinal fusion, where the surgeon aligns the vertebrae in your spinal column, and then uses metal rods and screws to hold the them together in the correct position. As your spinal bones heal, they fuse together. This procedure can prevent your spinal curve from getting worse.