Kyphosis: Difference between revisions

Kyphosis
Kyphosis
Specialty	Rheumatology

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For other uses of the term "kyphosis", see kyphosis (disambiguation)

Kyphosis in the sense of a deformity is the pathologic curving of the spine, where parts of the spinal column lose some or all of their lordotic profile. This causes a bowing of the back, seen as a slouching posture. Symptoms of kyphosis, that may be present or not, depending on the type and extent of the deformity, include mild back pain, fatigue, appearance of round back and breathing difficulties. If necessary, the deformity is treated with chiropractic care, a brace and physical therapy, or corrective surgery. Severe cases can cause much discomfort and even cause death. In patients with progressive kyphotic deformity due to vertebral collapse, a procedure called a kyphoplasty may arrest the deformity and relieve the pain.

Types

There are several kinds of kyphosis (ICD-10 codes are provided):

(M40.0) postural kyphosis, the most common type, normally attributed to slouching, can occur in both the old ^[1] and the young. In the young, it can be called 'slouching' and is reversable by correcting muscular imbalances. In the old, the aging body tends towards a loss of musculoskeletal integrity^[2]^[3], and kyphosis can develop due to aging alone ^[4].

(M42.0) Scheuermann's kyphosis is significantly worse cosmetically and can cause pain. It is considered a form of juvenile osteochondrosis of the spine, and is more commonly called Scheuermann's Disease. It is found mostly in teenagers and presents a significantly worse deformity than postural kyphosis. A patient suffering with Scheuermann’s kyphosis cannot consciously correct posture(2). The apex of the curve, located in the thoracic vertebrae, is quite rigid. The sufferer may feel pain at this apex, which can be aggravated by physical activity and by long periods of standing or sitting. This can have a significantly detrimental effect on their lives as their level of activity is curbed by their condition; they may feel isolated or uneasy amongst peers if they are children, depending on the level of deformity. Whereas in postural kyphosis the vertebrae and disks appear normal, in Scheuermann’s kyphosis they are irregular, often herniated and wedge shaped over at least three adjacent levels.

(Q76.4) congenital kyphosis can result in infants whose spinal column has not developed correctly in the womb. Vertebrae may be malformed or fused together and can cause further progressive kyphosis as the child develops(3). Surgical treatment may be necessary at a very early stage and can help maintain a normal curve in coordination with consistent follow ups to monitor changes. However the decision to carry out the procedure can be very difficult due to the potential risks to the child.

Treatments

Treatment for may involve anti-inflammatory drugs as well as exercises to strengthen the abdominal and hamstring muscles. Surgical treatment can be used in severe cases; however body braces are employed if surgery is deemed unnecessary, as the procedure is serious and consists of fusion of the abnormal vertebrae (4). Surgical treatment also has greater risk involved than a brace, for example as in any surgery there is a risk of infection, which could be potentially serious in the current situation of multiple drug resistant bacteria such as MRSA.

Dr. John Albert Odom, Jr., M.D. states that "while physical therapy (PT) doesn't help in severe cases of scoliosis, it is the mainstay of treatment for kyphosis. The sooner physical therapy is started, the more likely the child will not end up with a humpback. We recommend that PT be started as early as age 10." ^[5]

Physiotherapy

References

^ Annals of Human Biology, Volume 1, Number 3 / July 1974.
^ European Journal of Orthopaedic Surgery & Traumatology, Volume 9, Number 3 / September, 1999.
^ Spine, 2003 Mar 1;28(5):455-62.
^ Osteopathy: A Complete Health Care System, by Leon Chaitow N.D., D.O., M.R.O.
^ Spinal Deformities: Benefits of Early Screening and Treatment, by John Albert Odom, Jr., M.D.

External links

[1] Annals of Human Biology, Volume 1, Number 3 / July 1974.

[2] European Journal of Orthopaedic Surgery & Traumatology, Volume 9, Number 3 / September, 1999.

[3] Spine, 2003 Mar 1;28(5):455-62.

[4] Osteopathy: A Complete Health Care System, by Leon Chaitow N.D., D.O., M.R.O.

[5] Spinal Deformities: Benefits of Early Screening and Treatment, by John Albert Odom, Jr., M.D.

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 Treatment for may involve anti-inflammatory drugs as well as exercises to strengthen the [[abdominal]] and [[hamstring]] muscles. Surgical treatment can be used in severe cases; however [[body brace]]s are employed if surgery is deemed unnecessary, as the procedure is serious and consists of fusion of the abnormal vertebrae (4).  Surgical treatment also has greater risk involved than a brace, for example as in any surgery there is a risk of infection, which could be potentially serious in the current situation of multiple drug resistant bacteria such as MRSA.
+Dr. John Albert Odom, Jr., M.D. states that "while physical therapy (PT) doesn't help in severe cases of scoliosis, it is the mainstay of treatment for kyphosis. The sooner physical therapy is started, the more likely the child will not end up with a humpback. We recommend that PT be started as early as age 10." <ref>[http://medicalreporter.health.org/tmr0795/scoliosis0795.html Spinal Deformities: Benefits of Early Screening and Treatment,] by John Albert Odom, Jr., M.D.</ref>
 ==Physiotherapy==