Kyphosis (Hunchback) of the Spine

What is Kyphosis of the Spine?

Kyphosis of the spine is an abnormal upper-back rounding. The condition is sometimes referred to as “dowager’s hump,” “hunchback,” or “roundback.” Kyphosis of the spine causes a pronounced forward curvature of the spine. It can occur at any age but is most common in older women.

Most spinal kyphosis patients have few symptoms other than spinal deformity and require little or no treatment. More severe cases of kyphosis can result in debilitating pain, weakness, and trouble breathing. Breathing issues are caused by reduce space within the chest and reduced rib cage mobility reducing lung expansion.

Causes of Kyphosis of the Spine

• Posture
• Age Related
• Structural Abnormalities
• Injury
• Bone Growth abnormalities
• Congenital
• Osteoporosis / Osteopenia
• Microfractures

Symptoms of Kyphosis of the Spine

Symptoms of kyphosis vary from patient to patient, but may include:

• Rounded shoulders
• Head forward posture
• Obvious hump on the back “humpback”
• Mid to upper back pain
• Fatigue
• Stiffness
• Tight muscles in the back of the thighs (hamstrings)

In some cases, severe kyphosis can compress the spinal cord or spinal nerves. This is most common in patients with congenital kyphosis.

Kyphosis of the spine can also impact a person’s quality of life. Falls are a leading cause of disability and death in seniors and kyphosis doubles fall risk. Lower physical performance is common in elderly kyphosis patients because their motion and activity can be affected by this condition.

In a worst-case scenario, severe kyphosis (hunchback) can lead to chest deformity, which in turn affects the heart and lung function. Not only may you have trouble breathing, but this difficulty can lead to heart and/or respiratory failure. The compression from severe kyphosis may also cause gastrointestinal issues.

Types of Kyphosis of the Spine

There are several types of kyphosis:

• Postural Kyphosis: This is the most common type of kyphosis. It presents during adolescence. It is considered to be poor posture or slouching and is not associated with significant structural deformities in the spine. This type of kyphosis often improves with exercise.
• Age-related Kyphosis: Age-related kyphosis results from osteoporotic vertebral fractures or multilevel disc degeneration. It causes increased spinal curvature. Postmenopausal woman are more commonly affected.
• Scheuermann’s Kyphosis: The cause of Scheuermann’s kyphosis is unknown, however, it is associated with significant spinal deformities. With this type of kyphosis, the vertebrae become more wedge shaped with growth. While kyphosis generally affects women more than men, this type of kyphosis is more likely to affect males. Most cases are diagnosed between ages 13 and 16. In teenagers, cosmesis (physical appearance), is also an issue.
• Congenital Kyphosis: This type of kyphosis is present at birth and occurs when the spinal column fails to develop normally while the baby is in utero becoming more pronounced as the child grows.

Diagnosing Spinal Kyphosis

• Physical Exam: During a physical exam, the doctor will ask the patient to lean forward with both feet together and knees touching as the arms hang free. This enables the orthopedist to view the spinal slope and observe any deformities present.
• X-ray Imaging: X-rays may be ordered to visualize the spine from different angles, checking for vertebral changes or other bony abnormalities. The x-rays will be used to measure the forward curvature of the spine.
• MRI: Your doctor may order an MRI if appropriate. MRIs are necessary to view discs, spinal cord, and nerves. MRI uses a magnetic field and a computer to create clear, detailed images of spinal structures.
• Bone Density Testing: Your doctor may order bone density testing such as a DEXA scan. Osteoporosis and osteopenia are risk factors for compression fractures. These types of fractures can lead to kyphosis.

Kyphosis of the Spine Treatments

It is important to speak with your doctor or spine specialist if experiencing pain or symptoms in order to identify the best treatment options.

Conservative Treatments of Kyphosis:

• Monitoring and Imaging: Simple observation by your primary care physician or fellowship trained physician is done to monitor the forward spinal curve in order to see if it is getting worse with time. You may need periodic X-rays done under the supervision of a fellowship trained orthopedist. This is usually the only necessary treatment unless the curve gets worse or the patient experiences significant pain or breathing difficulties.
• Physical therapy: Therapy can help relieve back pain, improve posture, strengthen muscles, stretch tight hamstrings, and strengthen body areas that have been negatively impacted by a spinal curvature.

Surgical Treatment of Spinal Kyphosis

Spinal fusion is the most commonly used surgical procedure to treat kyphosis. It can reduce the degree of spinal curvature, maintain the improvement over time, prevent further progression of spinal curvature. Spinal fusion is a procedure that “welds” or fuses together the affected vertebrae together forming a single, solid bone arresting the progression of the curve.

When to See a Doctor for Kyphosis of the Spine

See a doctor for diagnosis and treatment if you experience pain from spinal kyphosis or any issues with mobility.
You should also see a doctor for kyphosis if you suspect the spinal curvature is affecting other parts of your body, such as your respiratory system.
If you feel you are experiencing symptoms of kyphosis, you should seek care with your primary care doctor, or consider consulting with a fellowship-trained spine surgeon. Contact us at Hoag Orthopedic Institute today!

To learn more about our Orange County Kyphosis treatment, please call to make an appointment at (949) 705-6493

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