Kyphosis is excessive, forward bending of the spine. It is mostly seen in elderly women but can affect people of all ages and men as well.
Age-related degenerative kyphosis is usually caused by minor cracks in the spinal bones causing them to become wedge shaped under body weight and pressure. In infants and newborns it is due to defects in formation of spine.
Mild kyphosis causes few problems. Severe kyphosis can cause pain and can be disfiguring.
Mild kyphosis may not cause any noticeable signs or symptoms. Some may experience back pain and stiffness in addition to an abnormally curved spine. Moderate to severe kyphosis causes respiratory problems and nerve compressions.
The vertebrae are stacked above one another into a continuous column. Vertebrae are joined with each other at 3 places. Kyphosis is caused when vertebrae become more wedge shaped due to any of the following reasons.
Fractures of the vertebrae mostly cause wedging of the vertebrae
Osteoporosis – Most common cause of kyphosis in older women. Also occur in people who have taken corticosteroids for long periods of time.
Disk degeneration. Disks are soft, circular cushions like material between spinal bones or vertebrae. Degeneration related to age, dries up and shrinks, worsening kyphosis.
Scheuermann’s disease. This disease begins during the growing years before puberty. Scheuermann’s kyphosis affects boys more often than girls.
Birth defects. Spinal bones that don’t form properly during the development in the mother’s womb can cause kyphosis.
Syndromes. Certain unknown disease clusters like Ehlers-Danlos syndrome and Marfan syndrome can cause kyphosis.
Cancer. Cancer of the spine can lead to weakness of vertebrae making them prone to compression fractures. Treatment for cancer like chemotherapy and radiation also causes weakness of spinal bones.
Infections. Infection like tuberculosis which is more prevalent in third world countries, can cause weakness and dissolution of the bones and other tissue of spine leading to kyphosis
Complications cause by kyphosis:
Back pain is most frequent complication and is often not relieved by conservative measures.
Breathing is restricted in severe kyphosis due to pressure on the lungs.
Physical activities limitations due to weakened back muscles and posture. It gets difficult to walk, get out of a chair, gaze upward or drive.
Digestion may get hampered due to compression of the digestive tract, causing acid reflux and difficulty with swallowing.
Cosmesis is a big concern in people with kyphosis
Diagnosis of kyphosis is made by evaluation of signs and symptoms and relevant tests:
X-rays or CT scans.
Bone density tests.
Treatment depends on the cause and severity of kyphosis:
Exercises. Stretching exercises are best to improve spinal flexibility and relieve back pain.
Brace. To stop the progression of kyphosis especially in children with Scheuermann’s disease, body brace is advised while their bones are still growing.
Surgery is done for severe kyphosis that is compressing the spinal cord or nerve roots. Spinal fixation with fusion is done for reducing the degree of curvature.
Wedging of the body of one or more vertebrae causing forward bending of spine causes Kyphosis. It can be caused by Fractures, Osteoporosis, Disk degeneration, Scheuermann’s disease, Birth defects, Syndromes, Cancer of spine and Infections.