Kyphosis

Introduction

Kyphosis is a condition in which the top of the back is excessively curved and appears more rounded than normal. While some degree of curvature is normal, a curve of more than 40 degrees would be considered a sign of kyphosis. Kyphosis doesn't usually cause any symptoms other than your back appearing slouched or hunched. Some cases may cause:

back pain and stiffness tiredness

Read more about the symptoms of kyphosis.

Treating kyphosis
Your course of treatment for kyphosis depends on the extent of the curve, whether there are additional symptoms such as back pain, as well as the underlying causes. Mild cases in children often don't require any treatment as many children grow out of kyphosis as their body matures. Alternatively, it may be possible to correct the spine using non-surgical treatments such as bracing. More severe cases will need surgery to correct the spine.

Types of kyphosis
Causes of kyphosis include bad posture or a structural problem with the spine.

The two main types of kyphosis are:

postural kyphosis this usually develops during the teenage years due to poor posture, such as slouching during childhood, which affects the normal development of the spine Scheuermann's kyphosis this also develops during the teenage years. For reasons that are still unclear, the vertebrae that make up the spine don't develop in the way they should, and the back takes on a curved appearance

A less common type of kyphosis is congenital kyphosis, which is when the spine doesn't develop normally in the womb. Kyphosis can also develop later on in life as the result of an underlying condition, such as osteoporosis (weakening of the bones).

Outlook
The outlook for many cases of kyphosis is good as symptoms tend to improve as a child grows older. More severe cases do carry a risk of causing complications, such as breathing difficulties or urinary incontinence, but these sort of complications would usually only occur if the condition was left untreated.

Symptoms of kyphosis
Many cases of kyphosis won't cause any noticeable symptoms other than a change in appearance of the upper back, giving a person a slouched or hunched appearance. (In mild cases of kyphosis, the change of appearance of the back may only be noticeable to a health professional with expert knowledge of the back). The most commonly reported symptoms of kyphosis are:

back pain stiffness and tenderness in the spine feeling unusually tired

In very severe cases, kyphosis can cause breathing difficulties and problems with eating. If you have severe kyphosis, your symptoms may get worse with time.

Treating kyphosis

Most cases of kyphosis don't require treatment. Kyphosis that's caused by bad posture (postural kyphosis) can normally be corrected by improving your posture. And kyphosis that's caused by abnormally shaped vertebrae (Scheuermann's kyphosis) will usually improve once you're fully grown.

Mild to moderate kyphosis

Over-the-counter painkillers such as ibuprofen or paracetamol can also help relieve symptoms such as back pain. Regular exercise and a course of physiotherapy may also be advised to help strengthen the muscles in your back. Teenagers with mild to moderate kyphosis may have to wear a back brace (a piece of equipment that supports your back). A brace will stop the curve from getting worse, and it's worn while the bones are still growing. You'll probably find wearing a brace restrictive at first, but most people get used to them with time. Modern braces are designed to be as convenient as possible, so you should be able to still take part in a wide range of physical activities. The brace will have to be worn until you're fully grown, which is usually around age 16 for girls and 18 for boys. (Bracing isn't usually recommended for adults who have stopped growing as it won't correct the position of the spine).

Surgery
Surgery can successfully correct the appearance of the back and relieve symptoms of pain. However, it carries quite a high risk of complication. This means that surgery would only be recommended in more severe cases of kyphosis. And only if it were felt that the potential benefits of surgery outweighed the risks. Surgery would normally be recommended if:

the curve of the spine is very large (more than 70 degrees) the curve is causing persistent pain that can't be controlled with medication

the curve is disrupting other important functions of the body, such as breathing and the nervous system without surgery it's likely that the structure of the spine would become even more deformed

Surgery is also normally recommended for babies who are born with congenital kyphosis. A technique called spinal fusion is usually used to treat kyphosis. This involves joining together the vertebrae that are responsible for the curve of the spine. Spinal fusion is carried out under general anesthetic (you're asleep throughout the procedure). An opening is made in your back, the curve in your spine is straightened using metal rods and hooks, and the spine is fused into place using bone grafts (a sample of bone taken from another place in your body usually the pelvis). This surgery takes between four and eight hours. You'll need to stay in hospital for around two weeks following the operation. Normally, you'll have to wear a cast or back brace for up to nine months. This is to support your spine while it heals. You should be able to return to school, college or work after four to six weeks, then be able to play sports about a year after surgery. Complications of spinal fusion surgery include:

post-operative infection excessive bleeding at the site of the surgery accidental damage to the discs of the back accidental damage to the nerves that run through the spine, which could then affect some of the functions of the body such as bladder control (urinary incontinence)

You should discuss the benefits and risks associated with spinal surgery with the doctor in charge of your care.