What is Kyphosis (Scheuermann’s disease; Roundback; Hunchback; Postural kyphosis)

Kyphosis Kyphosis is a curvature of the spine that develops into a bowing of the back, which leads to a ‘hunchback’ or slouching posture.

Statistics on Kyphosis (Scheuermann’s disease; Roundback; Hunchback; Postural kyphosis)

The prevalence of Kyphosis is estimated to affect 4-8% of the general population. While the prevalence of Kyphosis is generally accepted to be essentially equal in males and females, this finding is debated in literature.

Risk Factors for Kyphosis (Scheuermann’s disease; Roundback; Hunchback; Postural kyphosis)

In adults, kyphosis can be a result of osteoporotic compression fractures (fractures caused by osteoporosis), degenerative disease (such as arthritis), or spondylolisthesis (slipping of one vertebra forward on another). Other causes of kyphosis include the following:

  • Infection (such as tuberculosis)
  • Neurofibromatosis
  • Connective tissue disorders
  • Muscular dystrophy
  • Spina bifida (a birth defect involving incomplete formation of part of the spine)
  • Disk degeneration
  • Certain endocrine diseases
  • Paget’s disease
  • Polio
  • Tumors Kyphosis can also be seen in association with scoliosis (an abnormal sideways curvature of the spine seen in children and adolescents). Risk factors are related to the cause of the Kyphosis.

How is Kyphosis (Scheuermann’s disease; Roundback; Hunchback; Postural kyphosis) Diagnosed?

A spine x-ray will be done to document the severity of the curve and allow serial measurements to be performed. Occasionally, pulmonary function tests may be used to assess whether the kyphosis is affecting breathing.

Prognosis of Kyphosis (Scheuermann’s disease; Roundback; Hunchback; Postural kyphosis)

Adolescents with Kyphosis tend do well even if they need surgery, and the disease stops once they stop growing. If the kyphosis is due to degenerative joint disease or multiple compression fractures, correction of the defect is not possible without surgery, and improvement of pain is less reliable.

How is Kyphosis (Scheuermann’s disease; Roundback; Hunchback; Postural kyphosis) Treated?

Treatment depends on the cause of the disorder:

  • Congenital kyphosis requires corrective surgery at an early age.
  • Scheuermann’s disease is initially treated with a brace and physical therapy.
  • Occasionally surgery is needed for large (greater than 60 degrees), painful curves.
  • Multiple compression fractures from osteoporosis can be left alone if there is no neurologic problems or pain, but the osteoporosis needs to be treated to help prevent future fractures. For debilitating deformity or pain, surgery is an option.
  • Kyphosis secondary to infection or tumor needs to be treated more aggressively, often with surgery and medications. Treatment for other types of kyphosis depends on the cause. Surgery may be necessary if neurological symptoms develop.

Kyphosis (Scheuermann’s disease; Roundback; Hunchback; Postural kyphosis) References

  2. Kumar and Clark: Clinical Medicine 4th Edition (1998) pg 522
  3. MEDLINE Plus

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