Kyphosis

Overview

Kyphosis is an exaggerated, forward rounding of the upper back, often resulting in a hunchback appearance. It can occur in people of all ages, with different causes such as weakness in the spinal bones, malformation of the spine, or wedging of the spinal bones over time. Mild kyphosis typically causes no noticeable symptoms, but severe kyphosis can lead to pain, stiffness, and disfigurement. In addition, kyphosis can compress the digestive tract, causing digestive problems, and affect other body functions. Treatment options depend on the age, cause, and severity of the curvature.

Understanding the disease

Risk Factors

The risk factors for developing kyphosis may include:

1. Aging: As people age, the disks between the spinal vertebrae flatten and shrink, which can contribute to the development of kyphosis.
2. Genetic disorders: Certain genetic disorders, such as Scheuermann's disease and Ehlers-Danlos syndrome, can cause kyphosis.
3. Poor posture: Prolonged poor posture, especially in adolescents, can lead to the development of kyphosis over time.
4. Trauma or injury: Traumatic injuries, such as fractures or dislocations, can cause kyphosis.
5. Osteoporosis: Weakened bones due to osteoporosis can contribute to the development of kyphosis.

Development

Kyphosis can develop due to various reasons, depending on age and other factors. In older people, kyphosis is often caused by weakness in the spinal bones, which compresses or cracks. In infants and teens, kyphosis can be due to malformation of the spine or wedging of the spinal bones over time. Kyphosis can also be caused by genetic changes, such as in the case of KTS (Klippel-Trenaunay-Weber syndrome), where overgrowth of tissues occurs. Additionally, spinal bones not developing properly before birth can lead to kyphosis in children.

Assessment and Diagnosis

Triage

You should see a doctor if you notice an increased curve in your upper back or in your child's spine.

Diagnosis

To diagnose kyphosis, a health care provider will generally conduct a thorough physical examination, which may include checking your height and having you bend forward from the waist while they view your spine from the side. They may also perform a neurological exam to check your reflexes and muscle strength. In addition, the following tests may be ordered:

1. X-rays or CT scans: These can determine the degree of curvature and detect deformities of the vertebrae.
2. MRI: This can detect infection or a tumor in the spine.
3. Nerve tests: If you are experiencing numbness or muscle weakness, nerve tests may be ordered to determine how well nerve impulses are traveling between your spinal cord and your extremities.
4. Bone density tests: Low-density bone can worsen kyphosis and may be improved with medications.

Management and Treatment

Complications

Potential complications of kyphosis include limited physical functions due to weakened back muscles and difficulty with tasks such as walking and getting out of chairs. The spinal curvature can also make it difficult to gaze upward or drive and cause pain when lying down. Additionally, severe kyphosis can compress the digestive tract, leading to problems such as acid reflux and difficulty with swallowing. Other complications may include hepatitis, jaundice, anemia, thrombocytopenia, heart problems, complications involving the nervous system, swollen tonsils, and issues with breathing. It's important to consult a doctor if you notice an increased curve in your upper back or in your child's spine.

Treatment

Treatment for kyphosis depends on its cause and severity. In some cases, medications may be prescribed to help improve bone density and relieve pain. Exercise and bracing may also be recommended, particularly for children with Scheuermann's disease. Severe cases may require surgical intervention, such as spinal fusion. To prepare for an appointment, make a list of symptoms, medical history, and medications, and be aware of any pre-appointment restrictions. It's essential to follow your doctor's recommendations regarding physical activity and elevating affected limbs to manage kyphosis symptoms.

Preparing for medical consultation

To prepare for an appointment for kyphosis, you should:

1. Be aware of any pre-appointment restrictions: Ask your healthcare provider if there's anything you need to do in advance, such as restricting your diet or avoiding certain activities.
2. Write down any symptoms you're experiencing: Include any symptoms related to kyphosis, as well as any other symptoms that may seem unrelated to the condition.
3. Make a list of all medications, vitamins, or supplements you're taking: This will help your healthcare provider understand your overall health and any potential drug interactions.
4. Consider bringing a family member or friend: Sometimes it can be difficult to remember all the information provided during an appointment. Having someone with you can help you remember important details and ask any questions you may have forgotten.
5. Gather your medical records: Bring any previous scans or X-rays (including images and reports) and other relevant medical records to the appointment. This will help your healthcare provider understand your medical history and make informed decisions about your treatment. Remember to also prepare a list of questions to ask your healthcare provider during the appointment. This will ensure that you cover all the important topics and get the information you need.