Kyphosis (ancient Greek κύφος bent, hunchbacked) – in general cases, it is a curvature of the upper spine. It can be both acquired and hereditary.
Symptoms
Kyphosis, which occurs in the thoracic spine, is clinically manifested in the form of a “round back” syndrome (stoop; in more complex cases, hunchback). In this position, the patient’s shoulders are tilted forward and downward, the chest narrows. The main respiratory muscle – the diaphragm goes down, the abdominal muscles are weakened, the upper body is tilted forward. A long course of kyphosis leads to the appearance of a wedge-shaped deformation of the vertebrae, the destruction of intervertebral cartilage. From the side of the muscular system, stretching of the back muscles, dysfunction of the muscles that form the anterior abdominal wall are detected. A change in the anatomical structure of the chest cavity leads to a decrease in the mobility of the ribs, disruption of the activity of the intercostal muscles, and limitation of the respiratory function of the lungs.
Types, causes and treatment
Postural (postural) kyphosis , sometimes referred to as “round back”, is the result of poor posture. This condition is more common in teenagers and adults under 30 years of age. Constant slouching while standing or sitting leads to the formation of an anterior tilt. Postural kyphosis leads to the formation of lumbar hyperlordosis. Normally, in the lumbar spine there is lordosis – the curvature of the spine inward. Hyperlordosis means that the body, trying to compensate for increased kyphosis, compensatory increases lordosis.
Postural kyphosis is corrected by lying on a hard flat plane or stretching the spinal column (with weight on the bar). The radiograph does not reveal any changes, since the cause of this deformity is not structural damage or deformities. Postural kyphosis is easily corrected by personal control of your posture, learning how to sit and stand correctly. Traditionally, there is no need for special fixation and corsets. Complexes of exercises to strengthen the muscles of the back are always useful for correcting posture.
With juvenile Scheuermann’s kyphosis , the shape of several vertebral bodies changes. Their front part narrows, and the damaged vertebrae take the form of a wedge. In combination with each other, they form kyphosis of the thoracic spine.
Regarding the causes of Scheuermann’s juvenile kyphosis, there is still no final opinion. The genetic theory, and the theory of impaired vertebral growth due to impaired blood supply, received the greatest recognition.
In congenital kyphosis, a person is born with a defect, such as an incomplete formation of the spinal column, which can lead to severe pathological kyphosis. Extreme kyphosis is the most common underlying cause of paralysis in the lower body, following injury or infection. A large number of urinary disorders are associated with congenital kyphosis. If you suspect that you have this type of kyphosis, your doctor will likely prescribe a special x-ray of the kidneys – a urogram, an ultrasound, a myelogram, or an MRI. Myelogram or MRI shows compression of the spinal cord.
Severe congenital kyphotic deformities are traditionally treated surgically. Conservative treatments are less successful with this type of deformity. Early surgical intervention generally leads to good results and prevents progression of the deformity. The type of surgical treatment will depend on the individual characteristics of the deformity.
paralytic kyphosis. Diseases that cause paralysis can lead to the development of kyphotic deformity of the spine. Paralysis can be caused by disorders such as polio, muscular dystrophy, cerebral palsy (paralysis caused by trauma at birth or progressive defects in the brain or spinal cord). The development of kyphosis in such cases is gradual.
Posttraumatic kyphosis.Injury to the spinal column can lead to the development of progressive kyphosis with subsequent compression of the nerve structures of the spine. A compression fracture in the thoracic or lumbar spine will cause some degree of kyphosis. Depending on the severity of the injury, complex conservative or surgical treatment will be prescribed.
Postoperative kyphosis. With insufficient fixation and non-compliance with recommendations in the postoperative period, as a result of various operations on the spinal column, kyphotic deformity may form. This condition requires a second operation.
degenerative kyphosis.There are cases of development of kyphosis caused by degenerative-dystrophic changes in the spinal column. Over time, the degenerative process can lead to a defect in the intervertebral disc, changes in the vertebrae, weakening of the ligamentous apparatus that supports the spinal column. This can lead to the gradual development of kyphosis. In the initial stages of the formation of kyphosis, an imbalance of body mass develops, which accelerates degenerative processes in the spine, and as a result, accelerates the development of kyphosis, a circulus vitiosus (vicious circle) is formed.