Although some degree of curvature to the spine is normal, the term, kyphosis, is usually applied to the exaggerated curve that results in a rounded or hunched back. This condition can occur in adults for a variety of reasons, including degenerative disease, osteoporosis and tumors. It can also occur in relationship to congenital and developmental abnormalities.
Causes of Spinal Kyphosis
Kyphosis may develop for several reasons. Slouching and poor posture can stretch spinal ligaments. This can result in an exaggeration of the natural curve of the spine. This postural kyphosis usually begins to develop during adolescence. It is more common among girls than boys. It rarely causes pain. Exercises to strengthen the abdomen and stretch the hamstrings may help correct this form of kyphosis. As posture improves, the kyphosis naturally diminishes. Osteoporosis occurs later in life and may produce similar deformity of the spine. As the bones of the spine weaken and thin, they begin to deteriorate and compress upon each other. The result is a "dowager’s hump." Other serious forms of kyphosis may result from congenital defects or disease. Another unusual form of kyphosis occurs in some infants. It is the result of maldevelopment of the spinal column. The bones may not form as they should, or a bone bar may develop between two vertebrae and cause progressive kyphosis as the child grows. Children born with conditions such as spinal bifida, where there is incomplete development of the back of the spine, sometimes associated with neurological problems, usually have severe kyphosis. If kyphosis is present from birth, it will continue to worsen as the child grows. Surgical treatment and consistent follow-up are needed to maintain a more normal curvature. Scheuermann’s kyphosis is named after the Danish radiologist who first described this condition. It usually occurs during the teenage years. However, unlike postural kyphosis, Scheuermann’s kyphosis is more common among boys than girls. Again, it is not generally painful, although it does present a cosmetic deformity. The only sure way to tell the difference between postural kyphosis and Scheuermann’s kyphosis is with X-rays. The vertebrae and disks will appear normal in postural kyphosis. However, they appear irregular and wedge-shaped in Scheuermann’s kyphosis. Scheuermann’s kyphosis usually affects the upper (thoracic) spine, although it can also occur in the lower (lumbar) back area. When pain is present, it is usually perceived at the point of maximum curvature of the spine. Activity or prolonged standing or sitting can aggravate the pain. Degenerative or destructive lesions affection the spine or discs may also lead to collapse of the front of the spine and kyphosis.
Signs and Symptoms of Spinal Kyphosis
School screening programs often are the first to notice scoliosis. The symptoms that teenagers often complain of include the cosmetic deformity of a rounded back, or pain combined with poor posture. The doctor may ask the child to bend forward so that he or she can see the slope of the spine. X-rays of the spine will show if there are any bony abnormalities, and will enable the doctor to measure the degree of the curve. When the curvature of the spine is greater than 50 degrees, it is considered abnormal. In adults, destructive lesions may lead to pain over the affected area. If there is associated compression of the underlying nerves or spinal cord, neurological problems can develop. These can consist of weakness, numbness, tingling and problems with urinating or bowel movement. Due to the abnormal posture, the muscles must continuously hold the deformed spine upwards. In addition, adjacent sections of the spine extend backwards more than normal. Both of these conditions lead to muscle pains and aches.
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Medical Content Last Updated on 07/12/2008
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