kyphosis

Kyphosis refers to an excessive forward rounding of the upper back, or thoracic spine, resulting in an abnormal spinal curvature. It is commonly assessed on spinal X-rays, with the thoracic kyphotic angle measured by methods such as the Cobb angle. Normal thoracic kyphosis is typically about 20 to 45 degrees; hyperkyphosis describes a greater, fixed curvature, often around or above 50 degrees, which can affect posture and function.

There are several forms of kyphosis. Postural kyphosis is due to slouched posture, is usually flexible, and may improve with exercise and education. Structural or rigid kyphosis is fixed and may arise from conditions such as Scheuermann’s disease in adolescents, congenital vertebral anomalies, trauma, infections, or tumors. Degenerative kyphosis can occur in older adults as a result of osteoporotic vertebral compression fractures or degenerative spine changes. Rare secondary causes include inflammatory or metabolic conditions.

Symptoms range from visible rounded shoulders and a prominent back hump to back pain, muscle fatigue, and stiffness. In severe cases, kyphosis can impair respiratory function or reduce exercise tolerance. Diagnosis combines clinical examination with imaging; X-rays assess the Cobb angle and vertebral endplates, while MRI or CT may be used to evaluate underlying pathology.

Treatment depends on severity and cause. Mild postural kyphosis may respond to physical therapy, core strengthening, posture training, and activity modification. Bracing is commonly used in growing children with moderate curves to slow progression. In adults or progressive cases, interventions may include physical therapy, pain management, osteoporosis treatment, and, for severe deformities or neurologic compromise, surgical options such as osteotomy and posterior spinal fusion. Prognosis varies; many cases remain stable, but untreated severe kyphosis can worsen and affect quality of life.