Symptoms of kyphosis can range from unattractive posture, to pain, to severe problems of pressure on the lungs and abdomen. The pain occurs primarily in the area of the kyphosis. A severe curve can also begin to put pressure on the spinal cord and spinal nerve roots, which may cause weakness in the lower extremities. Eventually there can be pressure on the lungs and abdomen, affecting breathing and appetite.
The mid (thoracic) spine naturally has some kyphosis or “C”-shaped curve. A kyphotic spinal deformity means there is too much forward curve in the spine resulting in a rounded or hunch/hump back appearance.
Postural kyphosis-sometimes called “round back”-is the result of poor posture. This condition is most common in adolescents and young adults. Slouching when standing or sitting causes the spine to curve forward. Postural kyphosis is often accompanied by hyperlordosis of the lumbar (lower) spine. The lumbar spine naturally has a lordosis or inward curve. Hyperlordosis means the lumbar spine compensates for too much thoracic kyphosis by curving too far in the inward direction.
A postural kyphosis corrects itself when lying down on a flat surface, or when the spine is hyper-extended. There are no noticeable vertebral abnormalities on X-rays because structural damage or deformity does not cause this kyphosis. Postural kyphosis is easily corrected with education about proper posture, including some retraining on how to sit and stand correctly. Special bracing or casting is usually not necessary. Strengthening exercises for the back muscles can be helpful in correcting posture.
Non-surgical treatments are chosen first whenever possible and commonly include medications, exercise, and certain types of braces to support the spine.
If osteoporosis is present, treatment of the condition may also slow the progression of the degenerative kyphosis. This can be accomplished in several ways. The current recommendations include increasing calcium and vitamin D intake, hormone replacement therapy, and weight-bearing exercises.
The most common reason for kyphosis surgery is pain relief for chronic discomfort that keeps getting worse. Most cases of adult kyphosis surgeries are done to relieve severe pain. However, if the pain is manageable through conservative treatments, surgery will probably not be recommended.
Progression of the kyphosis deformity is another reason for considering surgery. If the curvature continues to worsen, surgery may be suggested. Surgery is recommended in this situation to prevent the problems that come from severe kyphosis.
When adult kyphosis requires surgery, doctors may choose many different procedures. Each case of kyphosis is somewhat different and may require a very specialized approach for optimal results. Surgery is suggested to solve the problems brought on by the kyphosis, not just to straighten the spine. The goals of most surgical procedures for adult kyphosis are to:
To achieve these goals, your surgeon may suggest an operation on the back of the spine, the front of the spine-or both. The goal is to first straighten the spine and then to fuse the vertebrae together into one solid bone (fusion).
Nearly all surgeons will use some type of instrumentation metal screws, plates, or rods, in order to help straighten the spine and hold the vertebrae in place while the fusion heals and becomes solid. The screws are placed into the vertebrae. The rods or plates then attach to the screws to connect everything together. Tightened together, they form an internal brace to hold the vertebrae in alignment while the fusion heals.