Kyphosis and lordosis are types of spinal deformities. While slight curvature of the spine is normal and healthy, there are some cases where it is over-pronounced and can cause both cosmetic deformity and health risks. When the spine curves inward too much in the low back, it is called lordosis. When the spine in the shoulder blade or mid-spine area has too much forward curve, or too much of a hump, it is called kyphosis. Kyphosis most often occurs in the thoracic area of the spine.
Some people are born with kyphosis when there is a naturally occurring abnormality in the spine. Kyphosis can also be an acquired condition. Teenagers in particular may develop kyphosis due to bad posture, especially girls between the ages of 12 and 15. Adolescent kyphosis is called Scheuermann's disease.
Compression fractures are often linked to the development of many cases of adult kyphosis, because they cause vertebrae to become wedged, reducing the amount of space between each vertebra. These fractures can occur as the result of degenerating discs, arthritis, osteoporosis and spondylolisthesis. Individuals with osteoporosis may develop kyphosis due to a weakening and compression in the vertebrae. Kyphosis in these individuals is treated with aggressive anti-osteoporosis action to prevent further bone weakening.
The symptoms of kyphosis are similar to those of scoliosis. These include uneven shoulders, chest, hips, shoulder blades, waist, or a tendency to lean to one side. In other cases, there are no visible symptoms. To diagnose a person with scoliosis, have them touch their toes. If either one or both shoulder blades are prominent, the waist is shifted or ribs are uneven, kyphosis may be present. Kyphosis is also called “hunchback” because of the hunched over appearance often seen in patients. Other symptoms include fatigue and difficulty breathing.
Outlined below are some of the diagnostic tools that your physician may use to gain insight into your condition and determine the best treatment plan for your condition.
When treating kyphosis, the cause of the disease must first be considered. Some cases require surgery early on, while other times, bracing and physical therapy may be the best course of action. Although bracing can help reduce pain symptoms, it is less successful at fixing the underlying problem of a curved spine, especially in adults. Strengthening and stretching programs can be successful at reducing symptoms. Swimming and other low-impact forms of exercise are beneficial. In cases which require surgical intervention, the goal is to reduce the curvature and relieve pain and discomfort over a long period of time.
Kyphoplasty is a surgical procedure offered at Dr. Regan's private practice that treats kyphosis caused by fractures of the vertebral body caused by osteoporosis or bone diseases such as multiple myelona. The surgery is minimally invasive, requiring only a very small incision in the back. A narrow tube is inserted through the incision using fluoroscopy to guide it into the correct position in the damaged vertebrae. Using the tube as a channel, the doctor then guides a special balloon into the vertebral body.
The balloon is then carefully inflated, restoring the vertebrae to a more normal shape. The balloon also creates a cavity in the vertebral body by compacting the soft inner bone material.
Next, the balloon is deflated and gently removed. Special instruments are then used to fill the cavity with a soft cement-like material which quickly hardens to stabilize the vertebrae. With the vertebrae shape and height restored, the pressure on the nerves is reduced, easing the pain.
Spinal fusion is a "welding" process by which two or more of the vertebrae that make up the spinal column are fused together with bone grafts and internal devices such as metal rods. The surgery performed by Dr. Regan eliminates motion between vertebrae segments. Spinal fusion may be used to treat abnormal curvatures such as scoliosis or kyphosis.
Bone is the most commonly used material to help promote fusion. Generally, small pieces of bone are placed into the space between the vertebrae to be fused. Sometimes larger solid pieces of bone are used to provide immediate structural support. Bone may come from the patient (autogenous bone) or a bank of bone harvested from other individuals (allograft bone). After the fusion procedure has been performed, the adjacent spinal segments are held immobile to allow fusion to progress. Immobilization is achieved through internal fixation devices or external bracing or casting. Both forms of immobilization may be necessary at times.
Normally, each vertebrae moves with respect to the one above and below it, allowing the spine to bend and rotate. A fusion means to fuse the two vertebra so that they cannot move on one another. Spinal instrumentation is often used to help provide stability for the spine after vertebrae have been fused together. Common types of instrumentation utilized at Dr. Regan's private practice include:
Not all causes of kyphosis can be prevented, but certain actions may reduce the possibility of developing kyphosis. These actions include good posture, good nutrition, consistent and sensible exercise, avoiding smoking, proper lifting, and accident prevention.
Surgery is always treated as a last resort, while more conservative methods are tried first. In general, surgery is considered when the curve exceeds 75 degrees. Other cases in which surgery may be recommended are for those suffering from chronic pain and/or a rapidly progressive curve.
Strengthening the back muscles can help prevent poor posture, which can lead to kyphosis. Osteoporosis, which can also cause kyphosis, can be prevented by getting enough calcium and vitamin D, exercising and strength training regularly.
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