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Hyperkyphosis

(Roundback of the Spine; Congenital Kyphosis; Postural Kyphosis; Scheuermann Kyphosis; Hunchback)

Definition

Hyperkyphosis is an excessive outward curve of the upper spine. It is sometimes called hunchback.

Early treatment can improve outcomes.

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Causes

In some people, the cause is not known. The three main types and their causes are:

  • Postural—caused by poor posture
  • Congenital—present at birth, often with other spinal problems
  • Scheuermann—a type that is genetic and appears during the teen years

Risk Factors

Scheuermann is more common in teenage boys.

Things that may raise the risk of hyperkyphosis are:

  • Poor posture
  • Problems that weaken the bones, such as osteoporosis
  • Having other family members with spinal problems
  • Nueromuscular problems, such as cerebral palsy
  • Trauma to the spine
  • Spinal infections

Symptoms

Problems may be:

  • Back pain or stiffness
  • Extreme rounding of the shoulders
  • A head that bends forward compared to the rest of the body
  • Differences in shoulder height
  • Fatigue

Diagnosis

This problem may be diagnosed during a routine exam or spinal check at school.

The doctor will ask about your symptoms and health history. A physical exam will be done. It will focus on the spine. This is often enough to make the diagnosis.

Images may be taken of the spine. This can be done with:

Treatment

Any underlying causes will need to be treated.

The goal of treatment is to stop the curve from getting worse. Choices are:

  • Observing a mild curve for any changes
  • Over the counter pain relievers
  • Physical therapy to learn exercises that improve posture and ease back pain
  • A back brace to keep the spine in line

Surgery may be needed by people with severe symptoms and those who are not helped by other methods. The goal of surgery is to correct the curve. This is done with a metal rod, hooks, or screws.

Prevention

There are no known guidelines to prevent this health problem.

RESOURCES:

North American Spine Society
http://www.spine.org

Ortho Info—American Academy of Orthopaedic Surgeons
http://www.orthoinfo.org

CANADIAN RESOURCES:

Canadian Orthopaedic Association
http://www.coa-aco.org

Canadian Orthopaedic Foundation
http://www.canorth.org

REFERENCES:

Acute low back pain. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/acute-low-back-pain. Accessed February 1, 2021.

Kyphosis. Boston Children’s Hospital website. Available at: http://www.childrenshospital.org/health-topics/conditions/kyphosis. Accessed February 1, 2021.

Kyphosis in children. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/kyphosis-in-children. Accessed February 1, 2021.

Kyphosis (roundback) of the spine. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00423. Accessed February 1, 2021.

Miladi L. Round and angular kyphosis in paediatric patients. Orthop Traumatol Surg Res. 2013 Feb;99(1 Suppl):S140-S149.

Last reviewed December 2020 by EBSCO Medical Review Board Teresa Briedwell, PT, DPT, OCS, CSCS  Last Updated: 2/1/2021