Kyphosis Symptoms & Causes

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When do normal spine curves develop?

In utero:

During fetal development, the primary curves develop (thoracic and sacral).

As babies:

All infants start life with a C-shaped spine. Their secondary curves (cervical and lumbar) develop as they become:

•  able to lift the head (cervical)
Regions of the spine•  able to sit up (cervical)
•  able to crawl, stand and walk (lumbar)

As children:

As children grow, their natural spinal curves continue to develop into a normal spine.

Different categories of kyphosis

Postural kyphosis

The most common type, normally attributed to slouching; can be treated by correcting imbalances in the musculature of the back, usually with exercise or bracing.

Scheuermann (juvenile) kyphosis

Usually more severe, more rigid and more cosmetically deforming; typically occurs in early-adolescent boys; can run in families; often requires brace or surgery.

Congenital kyphosis

Present at birth if a child’s spinal column did not develop normally in the womb; often requires surgery.

Symptoms of kyphosis

•   excessive rounding of shoulders
•   head bending forward compared to the rest of the body
•   shoulder height difference
•   difference in shoulder blade height or position
•   height of the upper back appears higher than normal when bending forward
•   tight hamstring (back thigh) muscles

Causes of kyphosis

•   postural (attributed to slouching)
•   congenital (present at birth due to abnormal development of the spine in utero)
•   neuromuscular (associated with a neuromuscular condition such as cerebral palsy or spina bifida)
•   related to metabolic conditions (internal body chemistry)
•   related to an infection or tumor
•   related to an untreated or poorly healed fracture
•   hereditary (sometimes runs in families)

Who’s at risk for kyphosis?

Risk factors for developing kyphosis vary. Common risk factors and predispositions can include:

•   a family history of spine problems
•   other birth defects
•   neuromuscular conditions
•   metabolic conditions that affect bones
•   syndromes that affect neurologic function
•   other genetic syndromes                                                                                

Are there any complications related to kyphosis?

•   Untreated kyphosis can become progressively worse and can become painful and deforming, and can result in
    lung problems, worsening deformity and pain.
•   If surgery is needed, there is a very slight chance of complications from the surgery, such as bleeding, infection
    or nerve damage.
•   A very small percentage of patients who have had surgery will need an additional procedure, usually for cosmetic
    reasons.
•   Older children and teens can have body image issues as a result of their kyphosis.

For teens

If you’re a teen with kyphosis, you have a lot to cope with. Besides the typical issues any teenager faces—from social acceptance to body image and more—you’ll also have to deal with medical appointments and procedures, some delay of your natural wish for independence, feeling different and assuming a big personal responsibility for maintaining your own good health.

The good news is that with successful treatment and your own compliance with bracing or other therapies, your kyphosis has a great chance of being corrected in the near future. But for now, if you feel self-conscious, depressed or anxious, speak to your doctor, nurse, parents or counselor—they’re all on your team, and they all want to help.

Prevention

Most spinal problems have no definite cause and/or no known method of prevention. Some are genetic in origin. Proper nutrition, prenatal care and vitamin consumption (especially folic acid) are always important if you’re pregnant, or if pregnancy is a possibility. If your family has a history of birth defects, consult a geneticist.

Kyphosis glossary

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  •   brace, bracing (spinal orthosis): If your growing child’s curve shows significant worsening or is already
      greater than 45 degrees, your physician may recommend a program in which a brace is designed specifically for
      your child’s particular curve. The brace holds your child’s spine in a straighter position while she’s growing in order
      to partly correct the curve or prevent it from increasing.

      There are many types of brace, including the Boston Brace developed at Children’s. A bracing program may help
      avoid surgery.

  •   congenital kyphosis:The spine forms and develops between three and six weeks after conception. Congenital
       kyphosis results from abnormal in utero spinal development, such as a partial or missing formation or a lack of
       separation of the vertebrae.

  •   (hyper-) kyphosis: A spine affected by kyphosis shows evidence of excessive backward curvature of the back
      bones (vertebrae) in the upper back area, giving the child an abnormally rounded or “humpback” appearance.
      Abnormal (hyper-) kyphosis is a type of spinal deformity and should not be confused with poor posture.

  •   neuromuscular: affecting, or characteristic of, both neural (nerve) and muscular tissue.

  •   orthopedics: the medical specialty concerned with diagnosing, treating, rehabilitating and preventing disorders
      and injuries to the spine, skeletal system and associated muscles, joints and ligaments

  •   orthopedic surgeon, orthopedist: a physician specializing in surgical and non-surgical treatment of the spine,
      skeletal system and associated muscles, joins and ligaments

  •   orthotics: the science of designing and fitting of devices such as braces to treat orthopedic conditions

  •   physical therapy: a rehabilitative health specialty that uses therapeutic exercises and equipment to help patients
      improve or regain muscle strength, mobility and other physical capabilities

  •   progression, curve progression: worsening of a spinal curve

  •   spina bifida (myelodysplasia): a condition in which there is abnormal development of the back bones, spinal
      cord, surrounding nerves and the fluid-filled sac that surrounds the spinal cord. This neurological condition can
      cause a portion of the spinal cord and the surrounding structures to develop abnormally. The defect can occur
      anywhere along the spine. Kyphosis can be an associated condition.

  •   spinal cord: a nerve bundle within the vertebral column that extends down from the brain stem; it conducts
      signals in both directions between the brain and extremities, and allows for bodily motion and sensation

  •   spinal abnormality: a condition in which the spine develops abnormally. Some abnormalities are present at
      birth, such as congenital kyphosis or congenital scoliosis. Some are the result of nerve or muscle (neuromuscular)
      diseases, injuries or illnesses—for example, cerebral palsy or spina bifida. In some cases, there’s no definite cause
      (idiopathic) or means of prevention for the spine’s failure to develop normally.

  •   spinal fusion: usually a solid fusion (solidification) of the curved part of the spine, achieved by operating on the
      spine, adding bone chips and allowing the vertebral bones and bone chips to slowly heal together to form a solid
      mass of bone called a fusion

  •   spine (spinal column, vertebral column): the series of vertebrae that move and form the axis of the skeleton
      and protecting the spinal cord

  •   spine curves, normal and abnormal: front-to-back and sideways curves of the spine

  •   All spines have normal front-to-back curves. Abnormal front-to-back curves can indicate “round back” (hyper-kyphosis)
      or “swayback” (hyper-lordosis).

  •   Normal spines do not have much sideways curvature. An abnormal sideways “S” or “C” curve can indicate scoliosis.

  •   vertebra, vertebrae: the individual spine bones that form the spinal column

  •   x-rays: a diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues,
      bones, and organs onto film

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