This lightweight option is custom fit and molded to the patient’s body to provide appropriate pressure in certain areas. For those needing bracing, a thoracolumbar (TLSO) brace or Boston brace is often ordered. However the location or type of brace may differ as each spine is different and therefore each brace should be custom fit to the patient. Bracing is similar to that used in scoliosis patients. Bracing is not an effective treatment for adult patients. The goal is to try and prevent further progression during times of rapid growth. The goal of physical therapy with spinal manipulation is to relieve patients’ symptoms related to their kyphosis but this will not change the underlying structural abnormality of the spine.īracing is commonly utilized for hyperkyposis, especially in those patients not yet skeletally mature. For those with a larger curve or symptoms of pain and stiffness a physical exercise routine can be beneficial. However, if this patient is still growing, close monitoring is essential to ensure it does not worsen over time. Often non-operative measures are utilized first including spine-specialized physical therapy and exercise regimens focused on improving overall posture, flexibility, and strengthening of the muscles surrounding the spine.įor patients with mild forms of kyphosis often formal treatment is not needed. Treatment options for hyperkyphosis vary depending on multiple factors including the patient’s age, potential for remaining bony growth, size of curvature, symptoms they are experiencing, and any underlying cause of their kyphosis abnormality. This also will occur in the setting of osteoporosis or spinal fractures or possibly after previous surgery. This often can be secondary to degenerative disc disease as asymmetric loading across the disc space changes the structural alignment of the spine. Hyperkyphosis can also occur due to other spinal issues that contribute to an enlarged kyphosis of the spine. This typically occurs during rapid periods of growth and patients may notice an increasing slouched appearance as the curve increases. Researchers believe there is an abnormal growth of the vertebral bodies leading to an abnormal wedge shape. Scheurmann’s kyphosis is defined by kyphosis greater than 40 degrees with at least 3 adjacent vertebral bodies that are wedge shaped greater than 5 degrees. This is most commonly diagnosed in adolescence between ages of 12-14 years and typically is greater in males than females. Scheurmann’s kyphosis is a common form of structural kyphosis. Patients may notice they are unable to stand straight and symptoms may worsen over time. Patients with structural kyphosis are unable to consciously change their posture to normalize their spine. Structural kyphosis is a hyperkyphosis not related to abnormal posture or slouching. A patient is able to correct this hyperkyphosis by standing up straight and there is no structural abnormality creating (remove this) excess curvature. A person will stand with poor posture and slouch their shoulders forward creating excess rounding across the thoracic spine. This is the most common type of kyphosis. There are several types of kyphosis including: If above that normal range it is termed as hyperkyphosis. A normal range of kyphosis is between 20 degrees and 40 degrees. If kyphosis is too elevated there may be a hunched or slouched appearance, often termed hunchback.Īs spinal specialists we evaluate a patient’s overall spinal alignment, paying close attention to each natural curvature as they can affect someone’s overall posture and quality of life. When evaluating from the side, kyphosis should seem like a gentle rounding behind the shoulders. Standing with good posture with our head above our hips minimizes the effect of gravity and allows us to use the least amount of energy when moving. The goal of these natural curves is to balance with one another so that a person stands with their head directly above their hips when evaluated from the side. The neck and low back areas are both lordotic curves meaning they curve inward, the low back often referred to as “swayback.” The thoracic spine and sacrum both curve outward referring to the term kyphosis. There are two lordotic curves and two kyphotic curves that alternate to create an “S” like shape. When evaluating from the side you notice these natural curves. When looking from behind it is normal to have a straight spine with the head centered over the pelvis. This may be a source of underlying back pain or a culprit contributing to an abnormal curvature of the spine.Īs spinal specialists we evaluate the spine through many different means but one of the most important is physical exam. Kyphosis is a normal outward curve of the spine but hyperkyphosis, or an enlarged outward curve, is an abnormal curving of the spine that can occur at any age.
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