Kyphosis
An excessive forward curve of the upper spine that produces a rounded or stooped posture and, in more severe cases, back pain or reduced function.
Quick Answer
Kyphosis is an excessive forward curvature of the upper spine that creates a rounded or stooped posture. It can result from poor posture, structural changes during growth, degeneration, or vertebral fractures. Mild kyphosis often causes only cosmetic concern, while more pronounced curves can cause back pain, stiffness, and, rarely, breathing or nerve problems. Treatment ranges from therapy and bracing to surgery for severe or progressive curves.
Key Takeaways
- Kyphosis is an exaggerated forward curve of the upper (thoracic) spine.
- Causes include posture, developmental changes, degeneration, and compression fractures.
- Mild kyphosis is often managed conservatively.
- Severe or progressive curves can cause pain and functional problems.
- Surgery is reserved for significant deformity, pain, or neurological concern.
At a Glance
| What it is | Excessive forward curvature of the thoracic spine |
|---|---|
| Common causes | Postural, Scheuermann disease, degeneration, fractures |
| Typical signs | Rounded back, stooped posture, stiffness |
| Possible symptoms | Back pain, fatigue, reduced mobility |
| First-line treatment | Physical therapy, posture training, bracing in youth |
| Surgical option | Correction and fusion for severe or progressive curves |
Symptoms
The most visible feature of kyphosis is a rounded upper back or stooped posture. Many people, especially with mild or postural kyphosis, have little pain. When symptoms occur, they can include back pain and stiffness, muscle fatigue, and a feeling of reduced flexibility.
In more severe curves, the deformity can be rigid and progressive, and in advanced cases may affect breathing or, rarely, compress the spinal cord and cause neurological symptoms. In older adults, kyphosis often results from multiple vertebral compression fractures related to osteoporosis.
Common Warning Signs
- A rounded upper back or stooped posture
- Back pain and stiffness
- Muscle fatigue with upright activity
- A curve that appears to be increasing
- Loss of height over time
When to Seek Care Promptly
- Rapidly progressing curvature
- Leg weakness, numbness, or coordination problems
- Difficulty breathing related to posture
- Severe pain after a fall
- Loss of bladder or bowel control
Diagnosis
Kyphosis is evaluated with a physical examination that assesses the curve, flexibility, and posture, including a forward-bend test. Standing X-rays measure the degree of curvature and help classify the type and monitor for progression.
MRI or CT may be used when there is concern about the spinal cord, an underlying structural cause, or when surgery is being planned. In older adults, imaging also evaluates for osteoporotic compression fractures contributing to the curve.
Treatment
Most kyphosis is managed without surgery. Physical therapy to strengthen the back and core, posture training, and treatment of any underlying condition such as osteoporosis form the basis of care. In growing children and adolescents with structural kyphosis, bracing can help control the curve during growth.
Surgery is considered for severe, rigid, or progressive curves, for significant pain that does not respond to conservative care, or when the spinal cord is at risk. Correction and fusion realign and stabilize the spine. At Atlantic Brain and Spine, deformity cases are reviewed through the spine board, and navigation may be used for precise instrumentation.
The Diagnosis-to-Treatment Pathway
1. Clinical evaluation
Examination assesses the curve, flexibility, and posture.
2. Standing X-rays
Imaging measures the curvature and monitors for progression.
3. Address underlying cause
Osteoporosis or other contributors are treated.
4. Conservative care
Therapy, posture training, and bracing in youth are used.
5. Advanced imaging
MRI or CT evaluates the cord and plans any surgery.
6. Surgical review
Severe or progressive curves are reviewed by the spine board.
7. Correction and fusion
Surgery realigns and stabilizes the spine when needed.
Frequently Asked Questions
Kyphosis has several causes, including poor posture, a developmental condition called Scheuermann disease that arises during growth, age-related degeneration, and vertebral compression fractures, which in older adults are often related to osteoporosis. The cause influences treatment.
Mild kyphosis is often a cosmetic or postural issue with little impact. More pronounced curves can cause pain and stiffness, and severe curves can, rarely, affect breathing or compress the spinal cord. The severity, rigidity, and progression of the curve determine how serious it is.
Postural and mild kyphosis often improve with physical therapy and posture training. In growing adolescents, bracing can help control a structural curve. Surgery is reserved for severe, rigid, or progressive curves or when there is pain or neurological concern.
It can, particularly when related to degeneration or osteoporotic compression fractures. Monitoring with periodic X-rays helps detect progression. Treating underlying osteoporosis and maintaining back strength can help limit worsening.
Surgery for significant kyphosis involves correcting the alignment and fusing the spine with instrumentation to hold the corrected position. It is reserved for severe or progressive deformity, and at Atlantic Brain and Spine it is planned through the spine board, sometimes using navigation.
No. Kyphosis is an excessive forward (front-to-back) curve of the upper spine, while scoliosis is a sideways curve. Some people have elements of both. They are evaluated similarly with examination and X-rays but are distinct conditions.
Specialists Who Treat Kyphosis
Your care is provided by Atlantic Brain and Spine's spine team, including fellowship-trained neurosurgeons and orthopedic spine surgeons.
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