If we look from the back of a person with a healthy spine structure, we will see that the spine is straight. In the side view of a healthy spine, there is a natural hollow in the neck and lumbar region, while there is a natural hump in the back region. However, in some cases, the hump in the back area may increase. A hump angle of 50 degrees or more on the back is called kyphosis. In a healthy spine, this angle is usually between 20-45 degrees. In short, kyphosis is a type of spinal deformity. Kyphosis in the spine may be congenital or may develop later due to various reasons. The most common type among the kyphosis that occurs later; kyphosis due to posture disorder. It is usually seen during adolescence in young people and there is no underlying structural disorder.
Kyphosis can sometimes occur as a result of spinal injury, fracture, or infection. In the advanced age group, kyphosis may develop as a result of collapse of the dorsal vertebrae due to osteoporosis.
The most common symptoms in kyphosis are; difference in shoulder heights, asymmetry in the scapula protrusions, more prominent back hump than normal when bending forward, excessive tension in the posterior thigh muscles.
In patients with kyphosis, low back pain, pain radiating to the legs, changes in urine and defecation habits are usually not observed. If these symptoms are present, you should go to the hospital immediately.
Early detection of kyphosis is very important for the treatment of the disease. The medical history of these patients should be questioned, a detailed examination should be performed and any necessary diagnostic tests should be performed. If the patient is a child, its story should be learned before and during its birth. It should be known whether there is a problem in pregnancy, the mode of delivery, and whether there is a difficult birth. It should be asked whether other members of the family have kyphosis. In order to evaluate some muscle diseases, it is necessary to learn about the milestone activities of the child such as sitting, crawling and walking. If there is a developmental delay, further medical evaluation is necessary. The following imaging techniques may be required꞉
X-Ray: A special spine X-ray is taken, in which the entire spine is viewed. Angular measurements of the curvature of the spine (kyphosis, scoliosis) are made in these X-ray films, also known as scoliosis radiography.
Magnetic Resonance Imaging (MRI): It is used to distinguish a spinal cord disease accompanying kyphosis.
Computed tomography (CT): It is used to evaluate decomposition defects in the spine that may cause kyphosis and to better understand bone-derived tumors and bone structure.
Bone scan (Skeletal scintigraphy): It is the imaging performed by administering a radioactive substance through the patient’s vein. Radioactive material is kept more intensely in places where cell activity is high. It is used in the diagnosis of spinal problems such as tumors and infections.
The approach in the treatment of kyphosis is determined according to the patient’s age, general health status, type of hump, cause and symptoms. The aim of the treatment is to slow the progression of the curvature in kyphosis and to reduce the deformity. Treatment options in kyphosis꞉
Follow-up and repetitive examinations: During childhood, curvature can be followed at regular intervals according to the patient’s age, bone maturity and degree of curvature. After bone maturity occurs, the potential for progression of the curvature weakens.
Physical therapy and exercise: Various exercises are recommended to strengthen the back muscles, correct the posture and increase the lung capacity. Especially those with postural kyphosis benefit greatly from exercise and rehabilitation.
Use of braces: A brace/corset can be used to slow the progression of the curvature in children who continue to grow. In women with kyphosis resulting from the collapse of the dorsal vertebrae due to osteoporosis, a thoracolumbar corset is also used.
Negative conditions that may develop due to kyphosis vary according to the type of curvature. In Scheuermann’s disease, the complaint of pain increases with activity or with prolonged sitting and standing. Lung functions may be adversely affected in patients with advanced kyphosis.
A hump angle of more than 50 degrees in the dorsal vertebrae is defined as kyphosis. In children and adolescents, the progress of the humpback angle should be followed closely.
Kyphosis is more common in women who have collapsed back vertebrae due to osteoporosis. The main purpose in the treatment of kyphosis is to stop the progression of the hump and to reduce the deformity.