What is Kyphosis?
Kyphosis is an abnormal outward curve in the upper spine. This produces a rounding in the upper back sometimes called “hunchback.” It can occur on its own or be present with scoliosis.
The spine has a natural curve to it to allow people to stand upright and provide balance. A slight outward curve (called kyphosis) in the upper spine is normal. This should measure anywhere from 20 to 45 degrees. Curves more than 50 degrees are considered abnormal. This excessive curve is called “hyperkyphosis.” The term “kyphosis” has come to be used for these abnormal curves.
Kyphosis can occur at any age. It is more common among teens, as this is a time when bones grow quickly.
Kyphosis can range from mild to severe. Mild cases may not cause any symptoms. They may not need treatment. More severe cases may result in a significant hump on the back. These cases may require surgery.
It is important to identify a curve in the spine early on. If treatment is needed, it can begin as early as possible. If treatment is not needed right away, your doctor will have a record of the curve. They can watch for changes as your child grows.
Types of Kyphosis
- Congenital kyphosis is present at birth when the spine does not fully form before birth. It may get worse as the child grows. Babies born with kyphosis often need surgery at a young age, so that the curve does not cause other health problems.
- Postural kyphosis is due to poor posture. It is more common in girls. It often shows up in teens. If not self-corrected by “standing up straight,” it can get to a point where physical therapy or bracing is needed to correct it. It does not usually lead to other problems later in life.
- Scheuermann’s kyphosis occurs when the spinal bones grow in an abnormal, wedged fashion. This type tends to run in families. It often appears in the teen years. It can continue to get worse as the child grows. Treatments can include physical therapy, medication, bracing and/or surgery.
Kyphosis Signs and Symptoms
Signs of kyphosis vary from child to child. They can include:
- Hump in the upper back, looks like child is hunched over
- Rounded shoulders
- Head appears to be bent forward
- Difference in height of the shoulders
- Less often: back pain, hard time breathing, extreme tiredness, tightness in the backs of the legs
Kyphosis Diagnosis
When we see a patient for kyphosis in the Crawford Spine Center at Cincinnati Children’s, we will:
- Perform a full evaluation of your child
- Review your child's medical history
- Perform tests to see if there are problems with the bones
- Measure the degree of curve in your child’s spine
- Order X-rays to figure out the exact angles of the curve
X-rays are the main test for kyphosis. Your child’s doctor might order other tests to gather more information. This could include MRI, ultrasound and / or CT scan.
Kyphosis Treatment
The Crawford Spine Center treats all types of kyphosis. We offer both surgical and non-surgical approaches. Treatment for kyphosis is based on several factors:
- The size of your child’s spinal curve
- How much longer your child will continue to grow
- The type of kyphosis your child has
We create treatment plans specific to each child. Your child’s treatment may include any of the following:
Non-Surgical Treatments
- Monitoring (watch and wait) – Includes routine X-rays so the doctor can watch for changes in the degree of the curve.
- Physical therapy – Exercises to help with back pain and posture.
- Medication – To help ease pain and increase range of motion.
- Bracing – To control the progress of the spinal curve while a child is still growing.
Kyphosis Surgery
- Spinal fusion – Allows two or more bones in the spine (vertebrae) to grow together (fuse) into one solid bone so the spine cannot bend.
Long-term Outlook
If congenital kyphosis is not treated, it can lead to severe deformities. It can cause neurologic issues due to pressure on the spinal cord.
When children are treated for kyphosis and get good follow-up care, they can go on to live active, healthy lives.
