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Kyphosis kī-ˈfō-səs

By David D. Sherry, MD, Professor of Pediatrics; Director, Clinical Rheumatology, University of Pennsylvania; The Children's Hospital of Philadelphia ; Frank Pessler, MD, PhD, Helmholtz Centre for Infection Research; Hannover Medical School, Braunschweig, Germany; Hannover, Germany

Kyphosis is an abnormal curving of the spine that causes a humpback.

The upper back normally curves forward somewhat. Some children have a greater degree of curvature. The excessive curvature may be

  • Flexible

  • Fixed (structural)

In flexible kyphosis, children can straighten the spine by tightening their muscles and the backbones (vertebrae) are normal. The cause is not known. Muscle-strengthening exercises may help, but no other specific treatment is needed.

In fixed kyphosis, children cannot straighten the spine because several of the vertebrae in the upper back are wedge-shaped rather than rectangular. Usually, 3 or more vertebrae are involved. Rarely, infants are born with fixed kyphosis, but it more commonly develops later in life, usually in adolescence. There are many rare causes, including fractures, infections, and cancer, but the most common cause is Scheuermann disease.

Kyphosis often causes no symptoms. Sometimes mild, persistent back pain develops. Kyphosis may be noticed only because it alters the body’s appearance. The shoulders may appear rounded. The upper spine may appear more curved than normal, or a hump may be visible. Some people have an appearance similar to those with Marfan syndrome, in whom the limbs are much longer than the trunk.

Mild kyphosis that does not cause symptoms is sometimes detected only during a routine physical examination. A doctor may confirm the diagnosis by taking x-rays of the spine.

Treatment is the same as described for Scheuermann disease (see Scheuermann Disease).

Kyphosis: A Humpback

Scheuermann Disease

Scheuermann disease is the most common form of fixed kyphosis. It usually begins in adolescence, affecting boys slightly more often than girls. The cause is unknown, but Scheuermann disease sometimes runs in families. Scoliosis (see Scoliosis) also often develops in children with kyphosis (called kyphoscoliosis).

Severe kyphosis is more likely to cause discomfort and sometimes can restrict chest motion, causing lung disease. Doctors confirm the diagnosis by taking x-rays of the spine.

Mild kyphosis can be treated by reducing weight-bearing stress and by avoiding strenuous activities. The spine may straighten slightly with treatment, although symptoms may not lessen. It is unclear whether treating mild kyphosis prevents the curve from worsening. When kyphosis is more severe, treatment most often consists of wearing a spinal brace or sleeping on a rigid bed. Treatment may lessen symptoms and prevent the curve from worsening. Rarely, despite treatment, kyphosis worsens to such an extent that surgery is needed to straighten the spine.

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