What is Kyphosis?
Kyphosis is a clinical condition characterized by forward bending of the spine. Normally, the spinal column has natural curve that enables it to keep an upright body contour and allow for effective transmission of weight and pressure along the spine. In kyphosis, the top of the spine is bent forward to an excessive degree, making it appear a lot more rounded than usual. From a clinical perspective, for bending exceeds 60° is considered to be kyphosis.
What Causes Kyphosis?
One of the most common causes of kyphosis is constantly maintaining an abnormal posture. This can include slouching at a desk, bending downwards and riding a bike, carrying heavy luggage on the shoulder etc. These activities can place undue stress on the ligaments and muscles that support the spine, eventually resulting in the vertebrae being misaligned and out of normal position.
Kyphosis can also be congenital meaning that individuals are born with the condition. This occurs when the vertebral bones are not formed properly and are of shape abnormally. Kyphosis can also occur secondarily to certain spinal conditions such as spina bifida, osteoporosis and muscular dystrophy, to name a few. Tuberculosis and Scheuermann's disease are other recognized causes.
Symptoms and Signs
Patients may not necessarily experience any particular symptoms from kyphosis. However, clinical examination makes it evident that the spine is abnormally bent forward. In advanced cases of kyphosis, patients may have difficulty looking straight ahead as the face is constantly looking downwards.
Diagnosis
A diagnosis of kyphosis can be made from clinical examination. However, this can be confirmed using x-rays that will demonstrate the abnormal curvature of the spine. In most cases further investigations are necessary but if patients are having a great deal of difficulty dealing with the degree of kyphosis they have, then further investigation such as a CT scan or MRI may be done to determine if spine surgery is necessary.
Additional tests may be conducted to diagnose any underlying illnesses such as tuberculosis or osteoporosis. Bone density scan is particularly useful.
Treatment
Patients with kyphosis generally do not require any particular treatment. If the patient is experiencing pain, regular over-the-counter painkillers such as paracetamol and non-steroidal anti-inflammatory drugs can be useful. Patients are requested to exercise regularly and if required a physical therapist may be involved.
In younger patients, back braces may be offered in an attempt to straighten the spine. Since the vertebral bones are still in a growing phase, the back braces can help them to grow in the right way.
In the event that patients have extreme kyphosis and are experiencing pain as a result, surgery may be offered. Spinal fusion is the surgical treatment of choice.
If kyphosis is left untreated, patients may experience complications such as low self-esteem (due to altered body image), problems with their breathing due to change in the shape of their thoracic cavity (cavity that contains the lungs i.e. rib cage) and persistent pain.