hyperkyphosis

Hyperkyphosis is an excessive forward curvature of the thoracic spine beyond the normal kyphotic range. In radiographic terms, it is commonly defined as a thoracic kyphosis angle greater than about 40–45 degrees. The condition can occur at any age but is most common in older adults and in adolescents with specific spinal disorders.

Common causes include osteoporosis with vertebral compression fractures, Scheuermann’s disease in adolescents, degenerative spine disease, congenital deformities, neuromuscular conditions, and spinal trauma. Less frequently, metabolic bone disorders may contribute.

Signs and symptoms often include a rounded or hunched posture, visible deformity, and height loss. Back pain or stiffness may occur, particularly with standing or activity, and severe cases can be associated with reduced respiratory effort or balance problems.

Diagnosis involves a clinical evaluation and standing lateral spine radiographs with measurement of the Cobb angle. A thoracic kyphosis angle exceeding the defined threshold supports the diagnosis of hyperkyphosis. Additional imaging, such as MRI or CT, may be used to evaluate underlying causes or nerve involvement. Bone density testing is commonly performed to assess osteoporosis risk.

Management depends on severity and etiology. Mild hyperkyphosis may be managed with observation, postural training, and targeted physical therapy to strengthen back extensors and improve flexibility. Bracing can slow progression in skeletally immature patients. Treatment of underlying conditions (bone health optimization, osteoporosis medications when appropriate) is important. Analgesia and activity modification may help with pain. In cases that are severe, progressive, or disabling, surgical options such as posterior spinal fusion with instrumentation or osteotomy may be considered.

Prognosis varies with cause and severity; untreated, advanced kyphosis can lead to chronic pain and functional impairment.