In humans, the spine has natural bends. If you look at the backbone, the spine should be straight and keep the body-centered over the pelvis. However, if you look at the spine from the side, it has bends designed to maintain balance, since the spine is located behind organs in the chest and abdomen. The spine has two kyphotic curves and two lordotic curves that alternate to create the letter “s” shaped. On the neck and lower back, there is usually an internal curvature or sagging back, known as lordosis. In this article, we will consider how to treat spinal kyphosis and what are the varieties.
The thoracic spine and sacrum have an external known curvature of kyphosis or hump. These curves tend to balance each other, so when we stand, we are well balanced with our head directly above our hips when viewed from the side. Standing in this position decreases the feeling of gravity, allows us to stand with better posture and use less energy when moving or walking.
Kyphosis affects the sagittal plane, or side view. The thoracic spine should have a soft rounding behind the shoulders. Normal chest kyphosis ranges from 20 ° to 40 ° when viewed from the side. If the curvature becomes greater, then the disease is present.
How to treat spinal kyphosis
Treatment depends on the patient’s age, degree of curvature, symptoms that the patient may experience, and the main causes of kyphosis. Most patients with kyphosis are first observed to see if the curve increases in size over time. During this time, physiotherapy and exercise programs improve posture and strengthen the muscles of the back. For patients with mild kyphosis, formal treatment is not always required. For patients who have pain or stiffness from their kyphosis, physical exercise, including muscle strengthening and aerobics, may be helpful. Physiotherapy and spinal manipulation can be used to treat the symptoms of kyphosis. These procedures can help relieve the symptoms associated with kyphosis, but usually do not cause changes in the actual structure of the spine.
For curves that are progressing, or in initially severe cases, a corset can be used to help straighten the spine and try to prevent further progression over subsequent years. Kyphosis lift is only used for patients who are still growing and are not an effective treatment for adult patients. How to treat kyphosis of the Scheuermann’s spine in growing adolescents with a similar fixation as for patients with scoliosis, but the location and type of corset may vary depending on the location of kyphosis. For patients who need a corset, the Boston lightweight corset is most often used. This lightweight brace is custom-made for the patient’s body, can be worn under clothes and allows patients to continue to participate in most sports and activities.
Treatment will depend on several factors, such as severity and underlying cause. For those who have a reason for poor posture, the good news is that aggressive treatment is not required. What may be required:
- Correction of fixation of the spinal joint.
- Yoga (to help build strength and range of motion).
If the cause of kyphosis is related to infection, then antibiotics may be required. If tumors are the primary cause, surgery may be required.
How to treat spinal kyphosis with surgery. Most patients with kyphosis do not require surgery. Spinal surgery for kyphosis is recommended for patients whose curvature continues to progress or cause symptoms despite conservative treatment. Corrective surgery for thoracic kyphosis is usually recommended when curves are greater than 80 ° – 90 ° when measured on x-rays. Kyphosis can extend in the middle or lower back, and in these cases, surgery is recommended for curves exceeding 60 ° to 70 ° kyphosis. Surgery is another option for patients with back pain turned off or when kyphosis leads to compression of the spinal cord or nerves.
Types of spinal kyphosis
The most common form of the disease is when poor posture. Patients with postural kyphosis can independently correct the curve by standing upright. There are no actual spinal structural abnormalities for these patients, and their curve is unlikely to progress.
It refers to an enlarged spinal curve that is not associated with posture. Patients with structural kyphosis cannot consciously straighten the spine. Patients with kyphosis may notice that they have difficulty standing upright or have constant pain in their back or legs. Symptoms usually worsen as the day goes on, and the patient will feel that he leans farther and farther forward, the longer he tries to stand upright. The severity of symptoms usually depends on the amount of kyphosis present.
The most common type of structural disease is Scheuerman’s kyphosis. Most often diagnosed at the age of 12 to 14 years. Scheuermann’s kyphosis is thoracic kyphosis, measured by more than 40 °, wedging three or more vertebrae in a row. The cause of Scheuerman’s kyphosis is unknown, but researchers believe that this is due to abnormal bone growth and development. This condition has a genetic predisposition and is most often observed and diagnosed during periods of rapid bone growth, for example, in adolescence. Most patients, first of all, notice poor posture or stoop and pain can develop in increased curvature.
The disease can occur from other problems or abnormalities in the spine. Any condition that leads to a decrease in height in the front of the spine can cause an increase in kyphosis. Common causes are caused by conditions such as compression fractures due to osteoporosis, other spinal fractures, or degenerative disc disease.
Diagnosis of kyphosis
The diagnosis is based on physical examination and x-ray examination. A complete medical history is noted to rule out other possible causes of kyphosis. An X-ray is used to assess spinal alignment and to measure total curvature when viewed from the front and back.
Kyphosis Scheuermann’s disease. If magnetic resonance imaging is done, then patients usually have Schmorl nodes, small hernias of the disc through the trailing plates of the vertebra. These disc hernias are different from hernias that occur in the area where the spinal nerves are located.
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