﻿ Kyphosis Symptoms, Causes, Treatment - When should you seek medical attention? - MedicineNet

Kyphosis (cont.)

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When should you seek medical attention?

Most cases of kyphosis are caused by postural changes and rarely progress to cause serious complications. However, any patient that develops signs or symptoms of kyphosis should be evaluated by a physician to rule out a more serious cause. Additionally, any patient with worsening of symptoms or who develops any weakness, numbness, or tingling in the legs or chest pain and shortness of breath should be seen by a physician.

What tests is your physician likely to obtain?

Your doctor will likely begin by obtaining your medical history, including when you first noticed your symptoms, any history of family members with similar problems, and other history of back or neck problems. A physical examination will then be performed. This will assess the curve of your spine both standing upright and while bending forward. Your strength, sensation, reflexes, and flexibility in your arms and legs will also be tested.

Based on the results of the history and physical examination, your physician may order X-rays of your spine. This can help differentiate postural kyphosis (normal shaped vertebrae) from Scheuermann's kyphosis (wedged-shaped vertebrae). If your doctor finds any evidence of neurologic injury, you may also obtain an MRI of your spine. This can identify any compression of the spinal cord or nerves. If you have any chest pain or shortness of breath, your physician may order additional tests to evaluate your heart and lungs.

How is abnormal kyphosis treated?

Postural kyphosis can usually be treated with physical therapy to help strengthen the muscles of your back and correct your posture. Mild pain relievers and antiinflammatory medications can also help with symptoms. These curves do not continue to worsen with time or lead to more serious complications. Surgery is not needed for postural kyphosis.

Scheuermann's kyphosis is usually initially treated with a combination of physical-therapy exercises and mild pain and antiinflammatory medications. If the patient is still growing, a brace can be effective. Braces are often recommended for curves of at least 45 degrees and can be continued until the patient is no longer growing. Your physician will likely obtain routine X-rays to monitor the degree of kyphosis over time. Bracing is not typically recommended for adults who are no longer growing.

In some cases, surgery is recommended for Scheuermann's kyphosis. The goals of surgery are to partially correct the deformity of the kyphosis, relieve pain, and improve your overall spinal alignment. Indications for surgery include a curve greater than 75 degrees, uncontrolled pain, and neurologic, cardiac, or pulmonary complaints.

There are various types of surgical procedures available depending on the specifics of each case. Surgery can be performed from the front (anterior approach), from the back (posterior approach), or both (combined anterior and posterior approach). This decision is made by your surgeon based on the specific characteristics of your curve. You may obtain X-rays bending forward and backward to determine how flexible your spine is. If it is flexible, a posterior approach may be adequate. If you are less flexible, you may need an anterior or combined approach. Regardless of the approach, the surgery involves partially straightening your spine and using rods and screws in the vertebrae to hold the spine while a bony fusion occurs.

Treatment of congenital kyphosis often involves surgery while the patient is an infant. This is because the kyphosis is caused by an abnormality in the developing vertebrae. Surgery earlier in life can help correct the kyphosis before it continues to worsen.

Sometimes kyphosis from painful collapse of vertebrae due to osteoporosis is treated with a procedure called a kyphoplasty, whereby a balloon is inserted into the affected vertebra and filled with a liquid (methymethacrylate) that hardens to restore the vertebral height. This procedure is a last resort after failure of noninvasive treatment.

Medically Reviewed by a Doctor on 6/2/2015

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