Kyphosis (Hunchback) and Its Treatment
Spinal Alignment from Birth to Old Age
From birth to old age, the sagittal (side) alignment of the spine undergoes continuous changes. During birth, the entire spine, from the neck to the coccyx, is in a forward-bent position. However, as the individual begins to stand upright, first a forward C-shaped curve forms in the lumbar region, followed by a reverse C-shaped curve in the thoracic region. Subsequently, four consecutive reverse curves develop in the neck, back, lumbar spine, and pelvis.
What is Adult Kyphosis?
Also known as hunchback, adult kyphosis is an excessive forward curvature of the spine in the thoracic region. The angle of the vertebrae in the back has surpassed the normal limits.
In normal lateral X-rays, the Cobb angle between the upper endplate of T5 (the 5th thoracic vertebra) and the lower endplate of T12 (the 12th thoracic vertebra) ranges from 10 to 40 degrees. An angle greater than 40 degrees is considered kyphosis.
What Causes Kyphosis?
Kyphosis, which can also develop genetically, has several known causes:
- Degeneration of the spine due to external factors
- Degenerative disc diseases caused by osteoporosis
- Fractures resulting from accidents or trauma
- Congenital abnormalities (e.g., myelomeningocele)
- Inflammation and infection in the tissues surrounding the spine
- Primary spinal infections like tuberculosis
- Neuromuscular diseases
- Tumors affecting the spine
What Are the Symptoms of Adult Kyphosis?
The most obvious symptom is the forward curvature of the spine. Common symptoms include:
- Stiffness and pain in the back and shoulders
- Constant numbness and weakness in the legs
- Excessive fatigue in the muscles
- Postural abnormalities, difficulty standing upright
- Shortness of breath and difficulty breathing
- Excessive sensitivity in the spine
How is Adult Kyphosis Diagnosed?
A simple test that families can perform may give an idea of the severity of the condition. If instructing your child to stand upright significantly corrects the visible hunchback, it is likely to be postural kyphosis. However, if the curvature does not correct, professional help should be sought.
For diagnosis, radiological tests are used to measure the angle of kyphotic curvature. In advanced cases, lung function tests should also be conducted. If kyphosis causes other symptoms such as urinary or fecal incontinence, MRI scans should be performed.
Can Hunchback Be Prevented?
The most common cause of hunchback is poor posture. If there are no underlying health conditions, individuals can benefit from exercises aimed at correcting kyphosis. Strengthening the muscles around the abdomen, chest, legs, and spine through exercise can help bring the hunchback into normal limits.
Can Adult Kyphosis Be Treated?
Kyphosis treatment depends on its severity:
- Mild cases (50-55 degrees): Can improve with regular exercise, proper posture, and correct techniques.
- Moderate cases (50-70 degrees): A kyphosis brace is recommended in addition to exercise.
- Severe cases: A surgical consultation may be necessary.
Physical therapy exercises, including reverse hyperextensions, can be beneficial. A kyphosis brace should be used under medical supervision and according to specific indications.