The spine has natural curves that alternate from top to bottom to better absorb the various pressures applied to it. The thoracic region of the spine has a “C”-shaped convexity; an exaggeration of which results in a condition called kyphosis. Kyphosis is characterized by an abnormal spinal curvature, which causes a physical deformity of the upper back commonly known as hunchback. Kyphosis mainly affects the thoracic spine, but sometimes the cervical and lumbar spine may also be affected as the curvature reverses from concavity to convexity.
Kyphosis may develop because of degenerative diseases such as traumatic injuries, osteoporotic fractures, arthritis, disc degeneration and slipped-disc. It can also be caused by malignancies or infections of the spine, poor posture, structural deformities such as scoliosis (abnormal sideward bending of the spine) and abnormal development of the spinal column before birth. If you have undergone radiation and chemo therapy for management of malignancies, you may have a risk of developing kyphosis.
Kyphosis can lead to back pain, weakness, fatigue, stiffness, tenderness and in severe cases, difficulty in breathing. When you present to the clinic with these symptoms, your doctor will take a thorough family and medical history, and perform a physical examination to evaluate the shape of the spine, strength of the muscles and neurological function to arrive at an accurate diagnosis. Various diagnostic tests such as X-rays, MRI and CT scans may also be performed to view the structures of the spine and evaluate the curve.
The treatment options for kyphosis can include conservative and surgical methods. Conservative treatment is the initial choice and includes pain and anti-inflammatory medications, exercises and supportive braces (in children) to support curves of more than 45°. If osteoporosis is the primary cause of kyphosis, slowing the progression of osteoporosis is recommended through the intake of vitamin D and calcium supplements, hormone replacement therapy and regular exercise.
Spinal surgery is considered for congenital kyphosis and kyphosis greater than 75° that is not relieved with non-surgical methods. The goal of surgery is to re-align the spine and fuse the vertebrae to form a solid bone and reduce the deformity. Metal screws, plates or rods are employed to hold the vertebrae in place during fusion.