What is kyphosis?
Kyphosis is the abnormal curvature of the thoracic spine (upper back) and can also develop in the cervical spine (neck) and lumbar spine (lower back). The deformity typically appears as an outward curve in the upper back that produces a hump or hunched forward appearance.
Everyone has a normal amount of curvature of the spine (up to 450) which provides space for the heart and lungs. Kyphosis produces curvatures greater than 500. Kyphosis may be discovered during a scoliosis screening at your child’s school or by their pediatrician.
Kyphosis is a disorder of the spine frequently seen in adolescents but can affect anyone at any age. Most cases are mild and can be monitored but generally do not cause problems and do not require treatment. Serious curvatures may warrant spinal fusion surgery.
What are the symptoms?
Symptoms include: A rounded upper back, a visible hump on the back, mild to severe back pain, fatigue, muscle stiffness and spasms, difficulty standing up straight and tight hamstrings.
What causes Kyphosis?
Postural Kyphosis in children and adolescents is the result of poor posture – slouching. It frequently affects adolescent girls, but generally doesn’t cause problems and is correctable with observation or postural exercises.
Scheuermann’s Kyphosis is a structural abnormality of the upper spine caused by abnormal rates of growth rates of the spinal discs and the spine during puberty. The abnormally shaped vertebrae thicken and push the spine out of position. It is often treated with monitoring, bracing and physical therapy. Surgery may be considered for severe deformity.
Congenital kyphosis is present at birth caused by a disruption of normal development in utero. There is a wide range of severity. Congenital kyphosis worsens as the child grows and can produce scoliosis, and other deformities. Children with congenital kyphosis may also have other birth defects including heart and kidney defects.
Congenital kyphosis is rare but can destroy the spine without treatment. Early growth-friendly surgery is the recommended procedure to re-align the spine and prevent progression.
Neuromuscular kyphosis results from some neurological diseases like cerebral palsy, spina bifida and muscular dystrophy. Surgery may improve quality of life.
Kyphosis may also develop due to the nutritional deficiency of Vitamin D, trauma and spondylolisthesis (abnormal slipping or dislocation of the vertebrae)
How is kyphosis diagnosed?
The first the concern is often the appearance of the child’s spine. Referral to a specialist is important to obtain an accurate diagnosis. Dr. Shufflebarger will review your child’s complete medical history, ask questions about your their symptoms and general health, and evaluate the curvature. He will also perform some common tests to assess your child’s balance, range of motion and muscle strength. Diagnosis is based on a physical examination and x-rays. Additional imaging studies may be required.
Treatment depends upon the cause, the age of the patient and the severity of the curvature.
Nonsurgical treatments are usually recommended to treat symptoms including pain management, physical therapy and bracing. Surgery is reserved for severe cases when the kyphosis is progressing, the patient is in severe pain that is not relieved with conservative management, the physical deformity is intolerable, the patient is at risk for or has developed neurological compression, and for children with congenital kyphosis.
Importantly, parents should understand that the it is vital to receive the services of a specialist in pediatric spine disorders. In addition to his many accomplishments in research and innovation in pediatric spine conditions, Dr. Shufflebarger is a kind and compassionate doctor who is sought out by parents the world over.