(Roundback of the Spine; Congenital Kyphosis; Postural Kyphosis; Scheuermann’s Kyphosis; Hunchback)
Kyphosis is a normal rounding curve that is seen in the in the upper back. Hyperkyphosis, or hunchback, occurs when the angle of the outward curve is exaggerated. The sooner hyperkyphosis is treated, the better the outcome.
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3 main types of hyperkyphosis and their causes include:
- Postural—the most common abnormal type, caused by bad posture
- Congenital—a type that is present at birth, frequently with abnormalities of the vertebral bodies
- Scheuermann—a type that is genetic, but appears during the teenage years
Other causes of hyperkyphosis are unknown.
Factors that may increase your chance of hyperkyphosis include:
Hyperkyphosis may cause:
- Back pain or stiffness
- Intense fatigue
- Exaggerated rounding of the shoulders
- Forward-bending head in comparison to the rest of your body
- Differences in shoulder height
Most cases can be diagnosed during a physical exam. Some cases are found at school during a scoliosis check. You will be asked about your symptoms and medical history. A physical exam will be done to look for abnormal curve in the spine, rounded shoulders, and a hump on the back. Some tests may be done to rule out or confirm other conditions that may be causing hyperkyphosis.
Your doctor may recommend imaging tests to see the spinal curve and the structures around it. These may include:
Your doctor may need to measure how well you breathe if the curve is severe. This can be done with pulmonary function tests.
There are a variety of treatments available for hyperkyphosis, depending on the severity. Additional treatment may be needed to resolve any underlying conditions that contribute to the hyperkyphosis. A referral may be made to a specialist who treats spinal disorders.
Options include the following:
An observation period may be advised to see if the curve progresses or if there are any changes in symptoms. Follow-up appointments will be needed.
A referral may be made to a physical therapist to learn specific exercises. This may include strength work, stretching, and overall conditioning. This will include learning how to maintain a correct posture. Sleeping on a firm mattress may be advised.
Nonsteroidal anti-inflammatory drugs (NSAIDs) may be given for pain or discomfort.
Braces are sometimes used. They may help reduce discomfort.
Surgery may be used when the curve is severe, progresses, or when other treatment methods fail. The goal of surgery is to correct the exaggeration of the curve. The spine is corrected with a metal rod, hooks, or screws in the back bones. Surgeons also use a bone graft to promote new growth and stability.
Vertebral compression fractures are sometimes treated with special cement. The cement is injected into the affected vertebral bodies to restore shape.
There are no current guidelines to prevent hyperkyphosis.
North American Spine Society
Ortho Info—American Academy of Orthopaedic Surgeons
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
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Kyphosis correction. Virginia Spine Institute website. Available at: http://www.spinemd.com/treatments/scheuermanns-kyphosis. Accessed November 15, 2017.
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Last reviewed November 2018 by EBSCO Medical Review Board Teresa Briedwell, PT, DPT, OCS, CSCS Last Updated: 12/20/2014