Kyphosis

What is this condition?

Kyphosis is excessive forward curvature of the upper or thoracolumbar spine. Causes include postural change, Scheuermann disease, congenital vertebral abnormality, osteoporosis fracture, infection such as tuberculosis, tumour, trauma or previous surgery. A flexible rounded posture is different from a rigid structural deformity.

What symptoms can it cause?

• Rounded back, difficulty standing upright or fatigue
• Focal pain, stiffness or skin pressure over a sharp prominence
• Nerve or cord compression causing weakness or gait change
• Severe deformity may restrict breathing or horizontal gaze

How is it assessed and diagnosed?

Standing full-spine X-rays assess angle, flexibility and balance. MRI looks for cord compression, tumour or infection; CT shows bone anatomy. Bone-density tests, infection studies and growth assessment are chosen according to age and suspected cause.

Treatment without surgery

Postural and mild flexible kyphosis is treated with education, strengthening and activity. Selected growing patients with Scheuermann disease may benefit from bracing. Osteoporosis, infection or tumour requires cause-specific treatment; exercise alone cannot correct a rigid collapsed vertebra.

When is surgery or a procedure considered?

Surgery is considered for progressive rigid deformity, neurological compression, severe pain, instability, threatened skin or cardiopulmonary compromise. It may involve decompression, osteotomy, realignment and long-segment instrumentation. The correction is limited by cord safety and bone quality.

Treatment and procedure options

• Physiotherapy and postural rehabilitation
• Bracing in selected growing patients
• Treatment of osteoporosis, infection or tumour
• Decompression and deformity correction with instrumentation
• Staged reconstruction for selected severe deformity

Risks from the disease and from treatment

Progressive kyphosis can cause pain, imbalance, cord injury and breathing limitation. Correction surgery carries blood loss, neurological injury, infection, implant failure, non-union and junctional fracture risks, especially with osteoporosis. No procedure is risk-free. General risks include anaesthetic problems, bleeding, infection, blood clots and delayed healing. Neurological risks depend strongly on the exact structure being treated and may include new weakness, numbness, speech or vision change, seizure, cerebrospinal-fluid leakage, need for another procedure or failure to obtain the hoped-for relief. The surgeon should discuss the risks that apply to the individual case.

Recovery and follow-up

Rehabilitation is staged and often prolonged. Nutrition, vitamin/bone management, smoking cessation and safe movement protect fusion. The goal is improved balance and function rather than cosmetic perfection. Recovery is not judged only by the first few days. Pain control, wound care, nutrition, safe mobilisation, physiotherapy and planned follow-up all matter. Some symptoms improve quickly after pressure is relieved; others recover gradually over weeks or months, and permanent nerve injury may not fully reverse.

Preparing for your consultation

Bring the original MRI/CT images or digital files, written reports, previous prescriptions, a current medicine list, and any operative or pathology records. For sudden warning symptoms, use the nearest emergency department rather than waiting for a routine appointment.

Authoritative patient-information sources

• AAOS OrthoInfo — Kyphosis: https://orthoinfo.aaos.org/en/diseases–conditions/kyphosis-roundback-of-the-spine/