Your spine — the intricate column of stacked bones and discs held together with ligaments, cartilage, and muscles — is the ultimate multitasker. It keeps you upright, allows you to twist and bend, and protects your vital central nervous system. From behind, your spine should appear stick-straight. A side-to-side curve indicates scoliosis.
From the side, your spine should have three natural curves. Your neck and lower back have a slight C curve called lordosis. Your middle back has a reverse 20-45 degree C shape called kyphosis. Anything above that range is considered hyperkyphosis, although it’s commonly called kyphosis, which is diagnosed when the curve measures 50 degrees or more. Loss of lordosis in your cervical or lumbar spine would be relative kyphosis. Any of these can be very disabling.
At McNulty Spine in Las Vegas and Henderson, Nevada, double board-certified Patrick McNulty, MD, FABSS, FABOS, leads the field in orthopedic surgery and treats all types of simple and complex spinal conditions, including kyphosis. Here, he takes a closer look at kyphosis, its types, causes, and risk factors to give you a better understanding of this challenging spinal condition.
Types of kyphosis
Kyphosis can affect anyone at any age, but more women than men have kyphosis. The symptoms vary depending on the severity and the cause, but generally include rounded shoulders, hunched back, stiffness, and inability to stand and walk up straight.
There are three main types of kyphosis, and each has unique characteristics, causes, and ages of onset.
The most common type of kyphosis — postural kyphosis — occurs as a result of poor posture. Parents usually notice postural kyphosis when their children reach adolescence. If you’re constantly reminding your child to stand up straight and stop slouching, they may have postural kyphosis.
The good news is that postural kyphosis doesn’t stem from a structural abnormality, which means your child can correct the problem with exercises that strengthen the support system around their spine.
As its name suggests, congenital kyphosis is a spinal defect present at birth. Although rare, it occurs in infants whose spines don't develop normally in the womb — either their vertebrae fuse together or they form abnormally.
Congenital kyphosis is progressive and will worsen as your child grows, so early treatment is critical. Severe congenital kyphosis can compress your child’s spinal cord and lead to neurological issues.
Named after the radiologist who first identified this condition, Scheuermann’s kyphosis is a structural problem with the vertebrae. In this type of kyphosis, the individual vertebrae develop in a triangular shape rather than a rectangle, as is normal. In essence, these triangles form wedges that create a forward curve of the spine resulting in an obvious hump.
Scheuermann’s kyphosis typically becomes noticeable in the early teen years and stops progressing once growth is complete. However, unlike postural kyphosis, this type causes pain and stiffness and cannot be resolved with exercise.
This is the most common kyphosis. 25% of the length of the human spine is due to discs. It is very common that discs will narrow as we age. As this occurs, the spine will lose relative length in the front, and we curve forward. Weak bone and collapse of vertebra can also cause loss of relative length in the front of the spine, and we curve forward. For some people, this can be a relatively balanced symmetric process, and we accommodate well. For others, it may be more severe in one or two regions of the spine, and cause more significant problems. When we lose the ability to stand up straight, life becomes more difficult, and inefficient. Attempts to stand up straight can become painful and futile.
This is a rheumatic disorder in which your spine is fusing on its own. The ideal goal is to it is limit the fusing, or effectively fuse in a good upright position. Fusing in kyphosis has become less common with more modern medications. If you do fuse in a kyphotic position, a functional upright life can be very difficult. Bracing in general is not effective. Once you have a fused kyphotic spine due to ankylosing spondylosis, the only treatment is complex spine surgery. Dr. McNulty is well versed in these procedures.
Are you at risk for kyphosis?
Kyphosis can be annoying at best and debilitating at worst, so it’s best to be informed and prepared in case you or a family member is at risk.
The risk factors for kyphosis depend on the type. You’re at high risk for:
- Postural kyphosis if you have poor posture and weak core muscles
- Congenital and Scheuermann’s kyphosis if it runs in your family
- Kyphosis later in life if you have degenerative disc disease or osteoporosis
As you age, your risk for kyphosis increases because the discs in your spine gradually deteriorate and shorten. In fact, up to 40% of adults over the age of 60 have kyphosis. But age is also a factor in osteoporosis, a disease that leads to weak and brittle bones. If you have osteoporosis, your vertebrae can easily fracture and compress your spine.
Kyphosis can be treated
Depending on the cause and severity of your kyphosis, Dr. McNulty develops a personalized treatment plan that addresses your unique situation. If your child has postural kyphosis, Dr. McNulty recommends special exercises that target their support structure. If the diagnosis is congenital kyphosis or Scheuermann’s kyphosis, they may need bracing and physical therapy to manage the curve.
In severe cases that restrict mobility and function, interfere with breathing and digestion, and cause pain, Dr. McNulty most likely will recommend surgical intervention to correct the spinal structure. If the underlying cause is weak bone, he can place you on bone strengthening injections, then definitively address the issue.
If you’re at risk for kyphosis or know you have it, schedule a consultation with Dr. McNulty by calling either of our two locations in Henderson or Las Vegas, or using our online booking tool.