Kyphosis

Kyphosis is popularly known as hunchback. The disease, which affects a wide range of people from young children to the elderly, can be life-threatening. The problem is defined as the forward curvature of the spine;

• While the forward curvature in the back exceeds normal
• The hollowing in the waist also disappears

This problem, which concerns the back and chest area, affects the quality of life not only physically but also psychologically.

What is kyphosis?

Kyphosis, which is visible when the spine curves forward, can be congenital or develop later in life.

• Hunchback in childhood triggers heart and lung disease
• A hunchback in old age reduces the lung capacity
• As the situation progresses, it sets the stage for life-threatening conditions at any age

Hunchback has limits that are considered normal when evaluated physiologically. Individuals may have different postures and natural kyphosis. The limit of hunchback varies between 20-50 degrees on a side x-ray taken while standing. Curvatures that exceed this value within normal limits are called kyphosis.

The normal curvature of the spine is important for balance. When the natural curve that allows a person to stand normally becomes larger or smaller, the posture becomes abnormal and it becomes impossible to stand upright.

• Kyphosis is a risk for patients of all ages
• It is more common during adolescence when bones are growing rapidly

The size of the curve determines the severity of the condition. The larger the curve, the more severe the condition. Back pain is common with mild curves that cause no symptoms. Severe curves cause deformity of the spine and a visible humpback.

Causes of kyphosis

Correct and timely diagnosis of the causes of congenital kyphosis can lead to an effective treatment plan. In addition to idiopathic kyphosis (unknown cause), tuberculosis, inflammation in the spine, spinal fractures caused by accidents or impacts, and destruction of tissues can be considered as causes of kyphosis.

What are the symptoms of kyphosis?

Symptoms of kyphosis are more or less common depending on the severity of the kyphosis. Symptoms vary depending on the cause, severity, and degree of the curve. The most common symptoms of kyphosis include

• Back or shoulder pain
• Deformity of the back
• Poor posture
• Extreme fatigue
• Shortness of breath leading to difficulty breathing
• Shoulders dropping forward

Symptoms of kyphosis in infants and children can vary. A doctor should be consulted before symptoms, which can be confused with those of other conditions, increase and begin to interfere with daily life.

Early diagnosis, proper treatment, and an effective exercise program can help reduce symptoms in the early stages of the disease.

Other causes of abnormal curvature include fractures, osteoporosis, degenerative disc disease, various syndromes, and cancer.

How to correct kyphosis?

History and physical examination can be used to diagnose kyphosis. Parents notice significant curvature. The family’s primary reason for seeking medical attention is concern about their aesthetic appearance. The physician takes a history and performs a physical examination. In early and mild cases, diagnosis may be difficult.

In advanced cases, further diagnostic tests are used to diagnose the disease. X-rays, pulmonary function tests, and magnetic resonance imaging are used to determine the effect of the disease on other organs, while pulmonary function tests determine lung function.

• Congenital kyphosis
• Developmental kyphosis and
• Correct assessment of traumatic kyphosis plays an important role in determining the treatment approach

Clinically, congenital kyphosis should be evaluated. The deformity is predicted to worsen as the child develops. Surgery should be performed when necessary, regardless of age.

If the postural deformity is associated with increased pain during daily activities, it is important to develop an effective treatment plan without wasting time.

Traumatic kyphosis can potentially cause neurological problems, including paralysis. The goal of treatment is to repair the spinal deformity, relieve pain, restore lost neurological function, and provide stability. This approach requires major surgery.

Can hunchback be prevented?

An exercise program is recommended for kyphosis caused by poor posture. Exercises to lengthen the leg muscles and strengthen the muscles around the spine can slow the progression of the disease.

Patients with increased curvature should undergo surgical treatment.

Surgery corrects the hump and prevents progression of the curve.

Kyphosis causes severe back pain as it progresses, while breathing problems and cosmetic problems cause psychological trauma. If the hump becomes permanent, it also negatively affects social life. It is extremely important to measure the hump and follow up the shoulder.

For back pain and hunchback caused by a sedentary lifestyle, swimming, along with proper and regular exercise, strengthens the abdominal muscles as well as the back.

Kyphosis Treatment Methods

The treatment method for kyphosis depends on the degree of the problem. Progressive degrees that exceed a certain limit require medical intervention. For childhood kyphosis exceeding 60 degrees, the use of a brace is recommended to slow the rate of progression. If the corset is used as recommended, the hunchback will regress to the desired level.

If the disease progresses despite the use of a corset, surgical intervention becomes mandatory. In order to eliminate life-threatening pulmonary problems, it is necessary to evaluate the recommendation of surgical intervention for quality of life.

The goal of surgery, which is urgently recommended for children, is to prevent heart and lung problems that may occur later in life.

How is a treatment plan for kyphosis developed?

The patient’s age, general health, amount of growth remaining, type of kyphosis, and severity of the curve are among the factors that influence the treatment plan. Depending on the patient’s needs, non-surgical methods are tried in patients with less than 70-75 degrees of curve, postural and Scheuerman kyphosis.

Non-surgical Treatment; In a treatment that emphasizes regular observation, it is extremely important that visits are regular and not interrupted. If the curve does not increase, there is no need for other treatment.

Specific exercises to relieve back pain and correct posture by strengthening the muscles. Non-steroidal anti-inflammatory drugs recommended by the doctor relieve the back pain and positively support the comfort of life. The recommended brace is used in different ways as needed until the skeleton matures and growth is complete.

Kyphosis Surgery

The first question that comes to mind at this stage is when surgical treatment is needed. Surgery is recommended for curves greater than 70-75 degrees. Surgery is also recommended for patients with congenital kyphosis. Surgery becomes inevitable if there is no improvement at the end of non-surgical treatment and the severity of back pain increases. The goal of successful surgery is to

• Reduce the degree of curve
• Stop the progression of the curve
• Relieve back pain
• Normalize physical and psychological life

Depending on the severity of the curve, the kyphosis surgery may include an “osteotomy,” which is the removal and correction of a piece of spinal bone.

• Although it varies from person to person, routinely the patient is able to walk 24 hours after surgery.
• He/she is discharged from the hospital within 3-4 days. Depending on the need, a short-term brace may be recommended after surgery.
• The estimated time for children to return to school is 3-6 weeks.
• Exercises such as walking and swimming are allowed after 3 months.
• By the end of the month, the patient can ride a bicycle.
• Sports that require hard contact cannot be played until the end of the first year.
• At the end of 1 year, the patient completely returns to normal life.

The surgical procedure should be tailored to the patient’s needs. Devices such as metal screws, plates, or rods may be used to stabilize the spine.

Risks of Kyphosis Surgery

Kyphosis surgery is an operation that should be taken seriously. However, time should not be wasted. During the surgery to correct the curvature of the spine, the necessary vertebrae are fixed from the neck to the lumbar curve. Ask your doctor. The improvements are permanent.

For children under the age of 10, independent rods are inserted to hold the vertebrae together while allowing them to interlock. The rods are lengthened as the child grows.

Kyphosis surgery prevents or delays the development of possible lung and heart disease. While solving skeletal and muscular problems, it restores the balance of the body to the shape it should be. The procedure is performed under general anesthesia.

The postoperative care of the patient continues in the intensive care unit for the first 24 hours, if necessary. Infection and high fever can occur after kyphosis surgery, which has different risks compared to other spinal surgeries. There are cases where the procedure may need to be repeated, and partial paralysis and dysfunction of any limb are among the low risks.

Surgical interventions supported by new generation applications use navigation technology.

The surgical site is dressed daily. Sutures should not be exposed to water for 15 days. Abundant fluid intake, anti-constipation measures and the use of the Alafranga toilet minimizes post-operative complications. Patients can start with easy walks to return to an active life without getting tired.

Kyphosis Surgery Price

Kyphosis surgery is necessary for the patient’s appearance and spinal health. It is extremely important that patients who are treated with corsets or other non-surgical methods do not lose their control.

The proper treatment plan varies from person to person. In the case of surgery, the appropriate plan should be made by the attending physician. The content of the surgery (level of instrumentation, type and number of osteotomies), length of hospitalization and personal applications play a decisive role in the cost of kyphosis surgery.

Frequently Asked Questions

After the diagnosis of kyphosis, a challenging and complex process begins for the patient and their family. The most accurate information can be provided by the physician who follows the patient. The answer to each question may not be the same for every patient, as characteristics vary from person to person. The answers to the questions most frequently asked by patients and parents are as follows.

Does kyphosis prevent height growth?

Kyphosis, which disrupts the posture of the body, is not a serious obstacle to height growth. Because of the postural deformity, the patient has the impression that the neck is shortened. A hunchback that occurs in early childhood is not an obstacle to growth. An effective treatment plan should be made in a way that does not hinder the child’s growth.

Will my height increase if my kyphosis is corrected?

No. In addition to reducing quality of life, kyphosis, which predisposes to various health problems, can be treated with surgery. By correcting the curvature of the body, a certain amount of growth in height can be seen in patients.

Does kyphosis improve with exercise?

Postural deformity and hunchback can be prevented with exercise. It is extremely important for beginners to do the exercises recommended by the doctor without interruption. Postural awareness and exercises are essential to the treatment of kyphosis. Proper exercise aims to stretch shortened muscles and activate weak muscles. Stretching and strengthening exercises are given to the patient according to a specific plan. For beginners, stretching movements start with 10 repetitions 2 times a day. It is recommended to stay in the stretching position for 10-15 seconds and then rest for 10-15 seconds.

How should people with kyphosis sleep?

The recommended mattress for kyphosis patients should be firm and flat. It is desirable that the mattress does not bounce with the body weight. A mattress that allows the head and torso to remain in harmony throughout sleep is ideal. Similarly, the pillow should not be too low or too high. Soft pillows are never recommended for this condition. Pillows that are too hard and too high cause the head to be forced back.

What is the ideal posture for people with kyphosis?

The head should be upright and facing forward. When viewed from the side, the ears should be in line with the shoulders. The chest should be upright, and the waist and neck hollows should be no more or less than normal. The position of a flat abdomen and straight shoulders should be maintained throughout the day.

How is kyphosis diagnosed?

The diagnosis of kyphosis is easily made by a physician’s examination, physical findings, and, depending on the patient’s history, various tests. The examination is usually diagnostic, but the most commonly used tests include x-rays, pulmonary function tests, neurological tests, or electronic scanning methods.