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Hyperkyphosis

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

Pronounced: ki–fo-sis

Definition

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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Causes    TOP

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.

Risk Factors    TOP

Factors that may increase your chance of hyperkyphosis include:

Symptoms    TOP

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

Diagnosis    TOP

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.

Treatment    TOP

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:

Observation

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.

Physical Therapy

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.

Medications    TOP

Nonsteroidal anti-inflammatory drugs (NSAIDs) may be given for pain or discomfort.

Back Brace     TOP

Braces are sometimes used. They may help reduce discomfort.

Surgery     TOP

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.

Prevention    TOP

There are no current guidelines to prevent hyperkyphosis.

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 Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T114958/Acute-low-back-pain. Updated October 25, 2017. Accessed November 15, 2017.
Kyphosis. Boston Children’s Hospital website. Available at:
...(Click grey area to select URL)
Accessed November 15, 2017.
Kyphosis. Seattle Children’s Hospital website. Available at:
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Accessed November 15, 2017.
Kyphosis correction. Virginia Spine Institute website. Available at:
...(Click grey area to select URL)
Accessed November 15, 2017.
Kyphosis (roundback) of the spine. Ortho Info—American Academy of Orthopaedic Surgeons website. Available at:
...(Click grey area to select URL)
Updated August 2016. Accessed November 15, 2017.
Lowe TG, Line BG. Evidence based medicine: Analysis of Scheuermann kyphosis. Spine. 2007;32(19 Suppl):S115-S119.
Wenger DR, Frick SL. Scheuermann kyphosis. Spine. 1999;24(24):2630-2639.
Last reviewed November 2017 by EBSCO Medical Review Board Teresa Briedwell, PT, DPT, OCS, CSCS
Last Updated: 12/20/2014

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