Scoliosis and Kyphosis

Scoliosis is an abnormal lateral (side to side) curvature in the spine curvature.  It may be diagnosed in childhood but often it isn't apparent until adolescence brings a growth spurt. Though scoliosis begins in adulthood, it can be exacerbated by arthritis, a condition called "degenerative scoliosis."

What Causes Scoliosis?

Although it's unclear what causes scoliosis, it often runs in families and occurs more often in girls than boys. Contrary to common belief, it is never caused by bad posture, heavy backpacks or lack of exercise. Though it is rare, some children are born with scoliosis.

What Are the Symptoms of Scoliosis?

A normal spine makes an "S" curve when viewed from the side and looks straight when  viewed from the front or back.  In a person with scoliosis, however, the spine viewed straight on appears to have a curve. Other symptoms:

• Tilted shoulders, hips or waist
• One collarbone juts out more than the other
• Fatigue after standing a short while, which occurs because the spine is not positioned correctly to support body weight
• Ribs on one side of the body may begin to protrude when scoliosis is severe, caused because the spine actually begins to twist
• Untreated, scoliosis can cause arthritis

When to Seek Treatment?

The younger a child is when curvature of the spine becomes apparent, the more likely it is that the scoliosis will worsen as the child grows. Therefore, it is important to seek treatment as soon as symptoms appear.  Untreated scoliosis may lead to chronic back pain and deformity and, in severe cases, can impede breathing because the ribs press on the lungs and heart.

How Is Scoliosis Evaluated?

• Your physician will conduct a physical exam to assess the shape, location, direction, angle and extent of your spinal curvature
• X-rays will confirm the diagnosis and pinpoint the degree of the curvature.

How Is Scoliosis Treated?

Scoliosis can be treated both non-surgically or  surgically, depending on the severity of the curve and the age of the patient.

Nonsurgical options

• Any curve under 22 degrees usually requires only monitoring, with regular checkups and X-rays.
• Curves between 22 and 40 degrees will be "braced" during the growing years, which won't correct the curve but will keep it from progressing. Today's braces are a vast improvement over older versions - they are typically pliable and can be worn undetected under clothing.  It may be removed for sports or other activities.
• Adults with degenerative scoliosis can be treated with physical therapy.

Surgical options

Curves over 40 degrees may need surgical correction.  This involves fusing two vertebrae together, using new bone.

Kyphosis

Kyphosis (sometimes called hunchback) refers to a condition where the spine is abnormally rounded in a forward direction, beyond the 40 degrees.

• Congenital kyphosis is present at birth and can run in families.
• Postural kyphosis is caused by persistent slouching and poor posture.
• Structural kyphosis is caused by:
• Arthritis of the spine
• Vertebrae fracture due to bone-density loss associated with aging (osteoporosis)
• One vertebrae slips forward and past another (spondylolisthesis)
• Disk degeneration
• Trauma
• Tumors
• Neuromuscular diseases, such as muscular dystrophy, polio and spina bifida
• Developmental. The curve shows up during a growth spurt in adolescence for no known cause (Scheuermann's Disease).

What Are the Symptoms of Kyphosis?

• Rounded back
• Spine feels stiff, achy or painful
• Fatigue after standing for a short while
• In severe cases, breathing difficulties

When to Seek Treatment?

The earlier kyphosis is treated, the better the result. Left untreated, it can lead to chronic back pain and deformity.  In severe cases, kyphosis can cause difficulty in breathing because the ribs press on the lungs and heart or neurological problems such as leg weakness.

How Is Kyphosis Evaluated?

• Your physician will conduct a physical exam to assess the shape, location, direction, angle and extent of the curve
• A pulmonary function test will assess whether  breathing is affected
• X-rays will confirm the diagnosis and pinpoint the degree of the curvature
• An MRI may be prescribed if the physician suspects that the spinal cord is affected

How Is Kyphosis Treated?

Stamford Hospital offers both non-surgical and surgical treatment for kyphosis, depending on the severity of the curve and the age of the patient.

Nonsurgical options

Postural kyphosis can often be helped with non-surgical treatment, such as:

• Physical therapy
• Back-strengthening exercises
• Switching  to a firmer mattress

Structural kyphosis usually results in a mild curve and may only require monitoring with regular checkups and X-rays.

• A more severe curve in children and adolescence may need to be braced during the growing years. While this won't correct the curve, it will keep it from progressing.  Note:  Today's modern braces are generally pliable, can be worn undetected under clothing and may be removed for sports or participation in other activities.
• Some cases benefit from physical therapy.
• Adults may find a brace helpful in controlling pain and discomfort.

Surgical options

In cases where curvature is severe or neurological symptoms are involved, surgery may be the best solution.  Children with congenital kyphosis typically benefit from corrective surgery at a young age.

Surgical options may include:

• Fusion: Verterbal bones are fused, using new bone for connection. 
• Vertebroplasty and kyphoplasty: These procedures involve injecting a cement-like substance  into the affected vertebrae, which can be quite effective in controlling pain associated with compression fractures.

Neuromuscular Scoliosis

When scoliosis is caused by disorders of the neurological system, including muscular dystrophy, spina bifida, cerebral palsy or spinal cord injuries, it is called "neuromuscular scoliosis." This can gradually worsen over time, as a child grows. Treatment must be tailored to the individual, but most children with neuromuscular scoliosis require surgery to prevent the curve from getting worse.

For more information or to make an appointment please call
1-877-233-WELL (9355).