The spinal cord is made up of three different segments. Each segment has its own natural curve. The upper cervical spine and the lower lumbar spine have c-shaped curves, while the middle segment, the thoracic spine, forms a reverse c-shaped curve. Problems occur when any part of the spine curves too much or too little. Kyphosis results when the thoracic spine curves too much. Most people develop this condition as adolescents and young adults, though it can occur at any age.
The spinal cord contains 24 small rectangular-shaped bones -- the vertebrae -- which stack on top of each other and create the natural curves within each segment of the spine. The vertebrae connect to create a canal that helps protect the spinal cord from injury. Intervertebral disks sit between the vertebrae, providing cushioning for the bones.
As mentioned, the thoracic spine naturally forms a reverse c-shaped curve. This curve is usually between 20 and 45 degrees. The medical term for a greater-than-average curve in the thoracic spine is hyperkyphosis. However, medical professionals often use the term kyphosis to describe any excessive curvature of the thoracic spine.
Kyphosis varies in severity. Typically, the greater the curve, the worse the symptoms. Mild curves in the thoracic spine may not result in any symptoms or may cause only mild back pain. More severe curves of the thoracic spine can result in the development of a hump. Additionally, a severe curve can compress the nerves in the spinal cord, leading to more serious symptoms such as weakness in the lower extremities and breathing difficulties. Severe cases of kyphosis can even interfere with heart function.
Postural kyphosis is the most common type of kyphosis. Postural kyphosis typically affects teenagers and young adults, and females more often than males. The condition develops due to slouching or slumping when one sits or stands. This type of kyphosis is not associated with severe structural deformities in the spine.
If a doctor suspects someone has postural kyphosis, he or she will take a medical history and perform a physical examination. During the exam, the doctor may ask the patient to bend over at the waist so the doctor can look at the spine from the side. The doctor may also test muscle strength and reflexes. After discussing symptoms, the patient may require x-rays to determine the severity of the curve in the thoracic spine. If muscle weakness is present, the physician may also order a test to determine how well nerve impulses are traveling between the spinal cord and the extremities.
Most of the time, physical therapy is sufficient to treat postural kyphosis. Physical therapists help those with postural kyphosis correct their posture through adjustments and exercises that help strengthen back muscles. Anti-inflammatory or pain medication can alleviate pain caused by postural kyphosis, as well.
Braces can also be utilized in the treatment of kyphosis. Some braces help correct posture while others strengthen the spine while an individual continues to grow. Some people may only have to wear a brace at night while others may need one for the majority of the day. The type of kyphosis and what the brace is designed to do will determine the length of time.
Teens and young adults who have postural kyphosis or must wear a brace to correct the condition may develop body image or self-esteem problems. Fitting in is important to many teens and young adults, and having to wear a corrective brace can lead to embarrassment and self-consciousness. As a result, some teens and young adults with this condition can be socially isolated.
It is rare to treat kyphosis with surgery, especially postural kyphosis. If a patient does require a surgical procedure, most of the time the surgeon will perform a spinal fusion, which fuses two or more of the affected vertebrae together to decrease the rounding of the back. New pieces of bone are attached to the vertebrae with metal rods and screws, and after a few months to a year, the vertebrae fuse or grow together. Surgeons typically prescribe physical therapy following spinal surgery, to help the back heal more quickly. While each situation is unique, most people who undergo spinal fusion surgery are able to resume normal activities within six to 12 months.
Most teens and young adults with postural kyphosis respond well to physical therapy exercises and pain medication. Even in rare cases where they require surgery, most can return to their usual routine once the spine has healed. With proper treatment, most people do not continue to have problems with postural kyphosis into adulthood.
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