kyphoses

Kyphosis is an abnormal curvature of the spine characterized by excessive forward rounding of the back, most evident in the thoracic region. The thoracic spine normally has a kyphotic curve, but when this curvature is exaggerated it is called hyperkyphosis or kyphosis.

Kyphosis can be physiological or pathological. Physiological kyphosis refers to the normal thoracic curve that can change with growth and posture. Pathologic forms include structural deformities such as Scheuermann’s kyphosis in adolescents, congenital kyphosis, and fixed deformities from fractures, tumors, infection, or inflammatory diseases.

Common causes include osteoporosis-related vertebral compression fractures, trauma, degenerative disc disease, and congenital vertebral anomalies. Aging, prolonged poor posture, and inflammatory diseases such as ankylosing spondylitis also contribute to hyperkyphosis.

Diagnosis relies on history and exam, with imaging to define angle and rigidity. The Cobb angle on lateral radiographs quantifies kyphosis; MRI or CT assesses underlying pathology, and bone density testing evaluates osteoporosis as a contributing factor.

Management depends on severity and cause. Mild cases may be observed with exercise and posture training. Bracing helps in growing children with Scheuermann’s disease. Treat underlying osteoporosis and provide physical therapy and pain relief. Severe fixed deformities may require surgery—posterior fusion with instrumentation, osteotomy, or vertebral resection; vertebroplasty or kyphoplasty may treat painful compression fractures.

Prognosis varies with cause and treatment. Many mild kyphoses remain stable; severe deformities may progress without intervention and can affect function and respiration.