Kyphosis is a curving of the spine that causes a bowing or rounding of the back, which leads to a hunchback or slouching posture.
Scheuermann’s disease; Roundback; Hunchback; Postural kyphosis
Causes, incidence, and risk factors
Kyphosis can occur at any age, although it is rare at birth.
Adolescent kyphosis, also known as Scheuermann’s disease, is caused by the wedging together of several bones of the spine (vertebrae) in a row. The cause of Scheuermann’s disease is unknown.
In adults, kyphosis can be caused by:
Degenerative diseases of the spine (such as
arthritisor disk degeneration)
Fractures caused by
osteoporosis(osteoporotic compression fractures)
Slipping of one vertebra forward on another (
Other causes of kyphosis include:
Connective tissue disorders
Infection (such as
Kyphosis can also be seen with
- Difficulty breathing (in severe cases)
- Mild back pain
- Round back appearance
- Tenderness and stiffness in the spine
Signs and tests
Other tests may include:
Pulmonary function tests(if kyphosis affects breathing)
MRI(if there may be a tumor, infection, or neurological symptoms)
Treatment depends on the cause of the disorder:
- Congenital kyphosis requires corrective surgery at an early age.
- Scheuermann’s disease is treated with a brace and physical therapy. Occasionally surgery is needed for large (greater than 60 degrees), painful curves.
- Multiple compression fractures from osteoporosis can be left alone if there are no nervous system problems or pain. However, the osteoporosis needs to be treated to help prevent future fractures. For debilitating deformity or pain, surgery is an option.
- Kyphosis caused by infection or tumor needs to be treated more aggressively, often with surgery and medications.
Treatment for other types of kyphosis depends on the cause. Surgery is needed if neurological symptoms or persistent pain develop.
Adolescents with Scheuermann’s disease tend to do well even if they need surgery, and the disease stops once they stop growing. If the kyphosis is due to
- Decreased lung capacity
- Disabling back pain
- Neurological symptoms including leg weakness or paralysis
- Round back deformity
Treating and preventing osteoporosis can prevent many cases of kyphosis in the elderly. Early diagnosis and bracing of Scheuermann’s disease can reduce the need for surgery, but there is no way to prevent the disease.