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Alternative namesScheuermann's disease; Roundback; Hunchback; Postural kyphosis
DefinitionKyphosis is a curving of the spine that causes a bowing of the back, which leads to a hunchback or slouching posture.
Causes, incidence, and risk factors
Kyphosis is a spinal deformity that can result from trauma, developmental problems, or degenerative disease. Kyphosis can occur at any age, although it is rare at birth.
Adolescent kyphosis, also known as Scheuermann's disease, results from the wedging together of several consecutive vertebrae (bones of the spine). The cause of Scheuermann's disease is unknown.
In adults, kyphosis can be a result of osteoporotic compression fractures (fractures caused by osteoporosis ), degenerative disease (such as arthritis ), or spondylolisthesis (slipping of one vertebra forward on another).
Other causes of kyphosis include the following:
Kyphosis can also be seen in association with scoliosis (an abnormal sideways curvature of the spine seen in children and adolescents). Risk factors are related to the causes.
Signs and tests
Physical examination by a health care provider confirms the abnormal curvature of the spine. The doctor will also look for any neurologic changes (weakness, paralysis, or changes in sensation) below the level of the curve.
A spine X-ray will be done to document the severity of the curve and allow serial measurements to be performed.
Occasionally, pulmonary function tests may be used to assess whether the kyphosis is affecting breathing.
If there is any question of a tumor, infection, or neurologic symptoms, then an MRI may be ordered.
Treatment depends on the cause of the disorder:
Treatment for other types of kyphosis depends on the cause. Surgery may be necessary if neurological symptoms develop.
Adolescents with Scheuermann's disease tend do well even if they need surgery, and the disease stops once they stop growing. If the kyphosis is due to degenerative joint disease or multiple compression fractures, correction of the defect is not possible without surgery, and improvement of pain is less reliable.
Treating and preventing osteoporosis can prevent many cases of kyphosis in the elderly. Early diagnosis and bracing of Scheuermann's disease can reduce the need for surgery, but there is no way to prevent the disease.
Update Date: 2/4/2003Ezra E. W. Cohen, M.D., Department of Medicine, The University of Chicago, Chicago, IL. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT