Kyphosis

Dr. Reetika Singh

Asst. Professor
 Introduction
• Thoracic hyper kyphosis is described as an excessive antero-posterior
curvature of the thoracic spine of greater than 40°.
• Normal kyphosis angles vary between
• 20° and 40° in the younger public
• 48° to 50° in women and about 44° in men.in older populations
• Kyphosis is an exaggerated, forward rounding of the upper back.
• In older people, kyphosis is often due to weakness in the spinal bones
that causes them to compress or crack. Other types of kyphosis can
appear in infants or teens due to malformation of the spine or wedging
of the spinal bones over time.
 Cont..
• Mild kyphosis causes few problems.
Severe kyphosis can cause pain and
be disfiguring. Treatment for
kyphosis depends on your age, and
the cause and effects of the
curvature.
 Causes

• The cause of kyphosis depends on the type:

• Postural: Poor posture, leaning back in chairs, carrying heavy bags.
• Scheuermann’s: Problem in your spine’s structure.
• Congenital: Issue developed in your spine before birth.
• Other causes of kyphosis include:
• Age, as your spine starts to curve more as people get older.
• Spinal injury.
 Causes

• The bones (vertebrae) that make up a healthy spine look like cylinders stacked in
a column. Kyphosis occurs when the vertebrae in the back become more wedge
shaped.
• The shape of vertebrae can be changed by:
• Fractures. Broken vertebrae can result in curvature of the spine. Compression
fractures, which can occur in weakened bone, are the most common. Mild
compression fractures often don't produce noticeable signs or symptoms.
• Osteoporosis. Weak bones can cause spinal curvature, especially if weakened
vertebrae develop compression fractures. Osteoporosis is most common in older
women and people who have taken corticosteroids for long periods of time.
 Cont..
• Disk degeneration. Soft, circular disks act as cushions between spinal
vertebrae. With age, these disks flatten and shrink, which often
worsens kyphosis.
• Other problems. Spinal bones that don't develop properly before birth
can cause kyphosis. Kyphosis in children can also be associated with
certain medical conditions, such as Ehlers-Danlos syndrome
 Clinical Presentation

• Hyper kyphosis of the thoracic spine can be postural or structural. Patients may
also present with a combination of both alignment impairments.

1. Postural impairments are flexible and respond to positional changes

or cues to change alignment.
• 2. Structural alignment impairments ie fixed alignments of the bony structures
persists regardless of the position of the individual. eg Scheuermann’s disease
• When there is a combination of structural and postural alignment impairments,
postural correction may only be partially successful. Kyphosis that started as a
postural fault may become a structural impairment (commonly is not painful
until a severe thoracic kyphosis has developed).
 Cont..
• Respiratory compromise. Thoracic hyper kyphosis could have
detrimental effects on breathing.
• Restricted spinal range of motion
• Osteoporotic fractures.
• Having difficulty getting up from a chair, out of bed, or out of the
bathtub
• Walking more slowly
• Feeling "off-balance," and/or losing your balance, or almost falling
• Feeling more tired than usual (fatigue)
 Cont..
• The primary sign of kyphosis is a visible forward curve in the upper part of the
spine. It causes the upper back to appear curved over, with the shoulders
rounded forward.
• In mild cases, the excess spinal curve is not very noticeable. In other instances, a
person may look as if they are bending forwards.
• Kyphosis often occurs without any other symptoms. However, other symptoms
can include:
• back pain
• stiffness in the upper back
• a rounded back
• tight hamstrings
 Types
• Postural Kyphosis
• Postural kyphosis, or postural round back, is thoracic kyphosis greater
than 50 degrees with normal-shaped vertebrae. This type of kyphosis is
flexible and often improves with exercises.
• Scheuermann’s Kyphosis
• Scheuermann’s kyphosis refers to a type of kyphosis where the
vertebrae have developed a wedge shape. This type of kyphosis is more
rigid and can worsen with growth. This occurs in 0.4 percent of the
population, with males and females affected equally.
 Cont..

• Congenital Kyphosis
• A diagnosis of congenital kyphosis assumes a difference in the shape of
one or more vertebrae. This difference is present at birth. The child is
noted at birth to have an outward curve of the spine. This curve may
become more noticeable with growth.
 Diagnosis

•X-rays or CT scans. X-rays can determine the degree of curvature and detect

deformities of the vertebrae. A CT scan might be recommended if your
doctor wants more-detailed images.
•MRI. Using radio waves and a strong magnetic field, MRIs can detect
infection or a tumor in your spine.
•Nerve tests. If you are experiencing numbness or muscle weakness, you
may need tests to determine how well nerve impulses are traveling between
your spinal cord and your extremities.
•Bone density tests. Low-density bone can worsen kyphosis and often can
be improved with medications.
 Treatment
• Medications
• Kyphosis treatment may include:
• Pain relievers. If over-the-counter medicines — such as acetaminophen
(Tylenol, others), ibuprofen (Advil, Motrin IB, others) or naproxen
sodium (Aleve) — aren't enough, stronger pain medications are
available by prescription.
• Osteoporosis medications. Bone-strengthening medications may help
prevent additional spinal fractures that would worsen your kyphosis
 Cont..
• Back brace: A Milwaukee brace or a supraclavicular brace are used to
prevent worsening and often even correct kyphosis in actively growing
children. The brace is prescribed by an orthopaedic specialist and made
by an orthotist. A brace is indicated in actively growing children with
kyphosis curves greater than 65 degrees. The brace is typically
prescribed to be worn 23 hours a day until the adolescent is done
growing.
 Surgery

• The most common kyphosis surgery is spinal fusion surgery. During this
procedure, surgeon:
• Lines up your vertebrae in a straighter position.
• Bonds them together by using small pieces of bone to fill the spaces
between your vertebrae.
• As your vertebrae heal, they fuse or join together. This procedure
reduces the severity of the curve to support your body better. It
prevents the curve from getting worse.
 Exercises for kyphosis

• Knee rolls
• Pelvic tilting
• Knees to chest
• Child Pose
• Cat and Camel Pose
• Thoracic Expansion
• Plank
• Superman Pose
• Thoracic Foam roll expansion
 Cont..
• maintain healthy posture while sitting
• If someone spends a lot of time sitting, it is important to practice a
healthy sitting position. To do this:
1. Position the chair so that when sat down, both feet can rest on the
floor. The knees should be at a 90 degree angle. If the chair is too tall,
or a person is using a desk that is too tall, use a foot rest.
2. Relax the shoulders so they are neither rounded, nor pulled back. Rest
the arms on arm rests so they sit at a 90–120 degree angle, and are
close to the body.
 Cont..

3. If using a desk or other surface, make sure it is at the same height

as the arms.
4. Use a chair that supports the curve of the lower back, or if
the chair does not have this support, add some using a cushion
or back rest.
• Remember to take frequent breaks to stretch.
 Cont..
• maintain healthy posture while standing
• To maintain good posture while standing, try:
• placing the feet shoulder-width apart
• putting most of the weight onto the balls of the feet
• standing straight and tall
• keeping the head level
• relaxing the shoulders down and back
THANK YOU