PARAMUS, N.J. -- Kyphosis, or a curvature in the sagittal plane with the apex of the curve directed posteriorly, exists as part of the normal spine alignment and can measure curvature of up to forty-five degrees. This varies from scoliosis, which exists when curvatures in the coronal plane have a minimum of 10 degrees.
The most common types of kyphosis include postural kyphosis and Scheuermann’s kyphosis. Postural kyphosis usually becomes noticeable during adolescence and is more common in girls than boys. Parents may see an abnormal prominence in their child’s posture, or it may be diagnosed by their pediatrician during a physical examination or with x-rays.
Most patients with postural kyphosis can correct their curve by maintaining proper posture and performing specific exercises. If that doesn’t work, an orthopedist may prescribe a brace until the curve is corrected or the child reaches skeletal maturity.
Scheuermann’s kyphosis is characterized by excessive kyphosis and structural change of the vertebrae. Patients with this deformity have a curve that is more rigid than with postural kyphosis.
When left untreated, Scheuermann’s kyphosis can progress with accompanying pain and cosmetic deformity. For a young patient with Scheuermann’s kyphosis and a small curve, less than 50 degrees, bracing can be an effective treatment. Physical therapy alone is not usually effective. Surgery may even be necessary for patients with large curves (greater than 70 degrees) and/or pain.
More sophisticated surgical techniques and instrumentation make surgical treatment for kyphosis easier to recover from than ever before. Patients who require only one posterior procedure (an incision in the back) are out of bed the next day. For those who undergo a second anterior procedure (through the chest), recovery may be more gradual. Patients may not need to wear a brace following surgery and generally experience minimal loss of motion.
Patients with good bone quality can achieve excellent results especially with physical therapy after surgery. Success is defined as a solid fusion that eliminates pain and in which the correction of the curve is achieved and maintained, providing a balanced spine.
Dr. Bernard Rawlins is an orthopedic spine surgeon at Hospital for Special Surgery specializing in spinal disorders from the cervical spine to scoliosis in both adults and children. He practices at both the HSS Outpatient Center in Paramus and the hospital’s main campus in New York.