In the normal state, the dorsal spine (located between the neck and the loins) has a curvature with posterior convexity. Conversely, the region of the neck and loins have a curvature with anterior convexity.
Kyphosis is an exaggeration of the convexity of the dorsal region giving the back a too rounded position. The cervical and lumbar parts of the spine present an exaggerated arching to balance the dorsal convexity related to kyphosis.
Kyphosis may be associated with scoliosis (lateral deviation of the spine) producing kyphoscoliosis.
There are several types of kyphosis:
- a) kyphosis of children and adolescents. It may be due to:
– a bad position: it is usually linked to insufficient back strength training. No significant deformity of the bones of the spine is identifiable.
-Scheuermann’s disease: it is due to an abnormality of growth of the dorsal vertebrae. The cause of this disease remains unknown. She affects boys more often than girls. It combines back stiffness, increased pain after prolonged sitting or exercise. The aesthetic deformity of the patient’s back is most often marked. A radiographic examination of the vertebral column makes it possible to make the diagnosis by showing a deformation affecting at least three consecutive dorsal vertebrae. The evolution of the disease stops at the end of the growth but the vertebral anomalies linked to the disease remain irreversible.
- b) kyphosis of young adultsis most often one of the symptoms of an inflammatory rheumatic disease called ankylosing spondylitis. This disease mainly affects the pelvis and spine and may involve a set of symptoms: joint pain occurring mainly at night, back stiffness, fever, fatigue, intestinal disorders. Its evolution is chronic and by pushes.
- c) kyphosis of the elderly subjectmay be related to:
-vertebral osteoporosis responsible for vertebral fragility and vertebral compression
a degeneration of the intervertebral discs (sort of pads located between each of the vertebrae)
Other, rarer causes may be responsible for kyphosis:
-a neuromuscular disease (such as polio )
a congenital malformation
Symptoms of kyphosis
Kyphosis results in pain sitting in the neck, back and loins.
At an advanced stage of its evolution (stiffness of the kyphosis), it is possible to observe a reduction of amplitude of the thoracic cage and an alteration of the respiratory, neurological, muscular and digestive functions of the patient.
Prevention of kyphosis
In any case, correct bad postures of the back and avoid carrying heavy loads.
Medical treatments of kyphosis
It depends on the cause (eg treatment of osteoporosis).
When kyphosis is linked to an incorrect stance, it is possible to improve the symptoms by strengthening the muscles allowing the patient to stand up straight.
The treatment of Scheuermann’s disease is based on several measures:
-to reduce as much as possible the carrying of heavy loads
-adapt working conditions (occupational therapy): avoid prolonged sitting with curved back
active kinesitherapy favoring respiratory movements to preserve the patient’s respiratory functions
-privilege non painful sports (swimming)
-if the patient’s growth is not complete, the wearing of appropriate corsets may be recommended, combined with back strength training
– Surgical straightening of the spine is indicated only in extreme cases (curvature greater than 70 °) and in the presence of intense pain resistant to conservative treatments.
In elderly people with kyphosis, deformity is often too advanced for corrective treatment to be achieved.