What is kyphosis (curvature of the spine)?
Kyphosis is curvature of the spine that causes the top of the back to appear more rounded than normal. A sign of kyphosis is a curvature of the back of more than 60 degrees. Sometimes kyphosis doesn't cause any symptoms other than the back appearing abnormally curved or hunched. However, in some cases the condition causes back pain and stiffness, tenderness of the spine, tiredness.
With severe kyphosis, symptoms may worsen over time, and breathing and eating may be difficult.
What causes kyphosis?
In kyphosis, the normal curve in the middle section of vertebral column (the thoracic vertebrae) is more curved than normal. There are a number of reasons why this might happen, including::
Poor posture (postural kyphosis) – slouching, leaning back in chairs and carrying heavy bags can stretch supporting muscles and ligaments, which can increase spinal curvature
Abnormally shaped vertebrae (Scheuermann's kyphosis) – if the vertebrae don't develop properly, they can end up being out of position
Abnormal development of the spine in the womb (congenital kyphosis) – if something disrupts the spine's normal development, two or more vertebrae sometimes fuse together.
Treatment of kyphosis
If you have kyphosis, your treatment depends on how curved your spine is, whether you have any additional symptoms such as back pain, and the underlying causes. Children with mild kyphosis may be able to be treated using non-surgical methods, such as bracing, to limit the progression of kyphosis as they grow.. Kyphosis rarely requires surgical treatment. It's only needed in some severe cases to correct the curvature of the spine.
Complications
Older children with kyphosis may become concerned or embarrassed about the effect the condition has on their appearance, or having to wear a back brace. These concerns can affect different children in different ways. Some children can become socially withdrawn and may be reluctant to take part in activities. There are no easy answers to these problems, but it can sometimes help to reassure your child that their feelings will improve with time.
Can kyphosis be prevented?
Postural kyphosis can be prevented by being aware of your posture and by taking care of your back. You should encourage your child to avoid slouching, sit correctly – sit upright, ensuring that all of the back is supported, avoid carrying heavy schoolbags, take regular exercise to help strengthen the back and keep it flexible; activities such as swimming, running, walking are ideal for helping to prevent back problems.
Diagnosis of kyphosis
Kyphosis can usually be diagnosed by examining your spine and taking an X-ray.
Spinal examination
During the examination, your doctor may ask you to do a number of exercises to assess whether your balance and range of movement are affected. Your doctor may also ask you to lie down so they can see whether the curvature of your spine is caused by bad posture or a structural problem.
X-rays and scans
An X-ray can usually confirm the diagnosis and determine the cause of the kyphosis. Further scans are usually only required if complex treatment, such as surgery, is being planned, or if you have additional symptoms that suggest your nervous system has been affected, such as numbness in your arms or legs.
Surgery
Surgery can usually correct the appearance of the back and may help to relieve pain but it carries quite a high risk of complications. Surgery is only recommended for more severe cases of kyphosis, where it's felt the potential benefits of surgery outweigh the risks.
Surgery for kyphosis would usually be recommended if:
- the curve of your spine is very pronounced;
- the curve is causing persistent pain that can't be controlled with medication;
- the curve is disrupting your body's other important functions, such as breathing and the nervous system.
