What is kyphosis
What is kyphosis?
Kyphosis, also called hunchback, is a colloquial term for a misalignment of the spine. In medical terms, kyphosis describes the backward curvature of the spine, while lordosis describes the opposite, namely the forward curvature.
The human spine contains a natural curvature forwards and backwards in its course. Naturally, kyphosis occurs in the chest area and at the lower end of the spine as a small kyphosis. If the spine curves excessively backwards in the chest area, the typical appearance of a round back is formed, known in technical terms as hyperkyphosis.
Which types of kyphosis do you differentiate?
Looking at the structure, one can distinguish between:
- Functional kyphosis: A hyperkyphosis that is caused by misalignment in other parts of the spine and that can be brought back into the normal position by compensatory movements
- Fixed kyphosis: This form can no longer be compensated, but is fixed in the pathological position by changes in the vertebral bones.
According to ICD-10 (International statistical classification of diseases and health related problems) classification, the following forms can be distinguished:
- Postural kyphosis is the most common form and affects both adults and adolescents. In the youth is through Muscular imbalances conditionally. In old age, hyperkyphosis arises from muscle wasting or vertebral body fractures.
- Scheuermann's kyphosis is a form of childhood disorder of the ossification of cartilage in the spine.
- Congenital kyphosis in infants can be the result of an incorrect development of the spine in the womb.
- Nutritional kyphosis describes the disease caused by malnutrition. Vitamin D deficiency can, for example, lead to softening of the bones and thus to a misalignment of the spine.
- Gibbus-forming deformity
- Post-traumatic kyphosis
Causes of a hunched back
In general, a distinction is made between congenital and acquired hyperkyphosis. These misalignments can exist from birth, e.g. due to incorrectly shaped vertebral bodies such as half vertebrae or block vertebrae. As the causes of the acquired form can be responsible:
- Muscular insufficiency and the resulting bad posture
- Tumors and metastases
- Degenerative and inflammatory diseases such as arthritis, rheumatism , osteoporosis or ankylosing spondylitis
Another cause is that common in adolescence Scheuermann's disease . In this disease, the front and back thoracic vertebrae grow unevenly, resulting in an incorrect curvature of the spine.
In milder cases, training the correct posture through regular exercises for the back muscles is sufficient. Regular exercise is recommended as exercise can improve the deformity. The therapy is generally based on:
- Cause of kyphosis
- the degree of expression
- the age
- possible comorbidities of our patients
- the expected growth
If the hyperkyphosis is detected in good time, the deformity can be corrected through physiotherapy and wearing a corset, so that no surgery is necessary.
Indication: When does kyphosis surgery make sense?
If the hyperkyphosis progresses, surgery can be considered. It is designed to prevent severe hyperkyphosis that can occur after vertebral body fractures. In general, operations with the following indication can be indicated:
- marked increase in kyphosis
- neurological hazard
- Conservatively uncontrollable pain
- endangered stability of the spine
- cosmetic desires
Congenital hyperkyphosis requires surgery as soon as possible, as unnecessary waiting can have serious neurological and motor consequences for the child. The indication for Scheuermann's kyphosis is strict and, in addition to the points mentioned above, also depends on the angle of the vertex of the kyphosis.
Procedure and surgical methods for kyphosis
If the vertebral fracture is involved, one can Kyphoplasty be performed. This is a minimally invasive procedure for treating these fractures. The procedure is typically performed in the prone position under fluoroscopy. Most of the time, the operation is performed under general anesthesia. In the conventional procedure, one or two balloons are inserted through small incisions to straighten the broken vertebra. The cavity created during inflation is filled with bone cement. This stabilizes the vertebral body and prevents further collapse.
To stabilize the spine, the procedure can also be used Spinal fusion be performed. In order to create a stable spine with physiological curvature, unstable vertebral bodies are connected to the neighboring vertebra during the operation. This connection is made using screws, rods and plates that remain in the body as implants and are supposed to grow into the vertebral bodies. At the end, a thin tube is inserted into the operating area, through which blood and wound fluid can drain off after the wound has been closed. Then the wound is sutured and covered with a plaster.
Risks and possible complications of kyphosis surgery
The main complications of cement filling in kyphoplasty are leakage of the liquid bone cement from the vertebral body. The risks of general anesthesia should also be made clear to the patient for this minor procedure. Postoperatively, the anesthetic can cause nausea, dizziness and headaches come. By introducing foreign material and cutting the skin, pathogens can get inside the body and cause infections and inflammation. With spinal fusion, another operation may be necessary if the inserted implants are not seated securely and need to be repositioned.
Hospitalization and Follow-up Care
No bed rest is required after a kyphoplasty. A few hours after the operation, the patient is allowed to get up and move around normally when accompanied. As with all vertebral surgeries, short-term bracing is recommended in some cases. To ensure that there is as little pain as possible after the operation, in many cases a so-called pain catheter is placed during the operation, which remains for a few days after the operation, if necessary. A hospital stay of 4-6 days is recommended after spinal fusion.
Which doctors and clinics are specialists in kyphosis treatment?
In clinics or practices for orthopedics and trauma surgery, those affected can find out about their treatment methods for hunched backs. If an operation is necessary, it is carried out by specialists in orthopedics and trauma surgery who have advanced training in spinal surgery.
We help you to find an expert for your illness. All listed doctors and clinics have been checked by us for their outstanding specialization in the area of kyphosis (hunchback) and await your inquiry or your treatment request.
- Wirth et al .: Specialist examination in orthopedics and trauma surgery, 1000 commented examination questions . 2nd Edition. Thieme 2013, ISBN 978-3-131-40652-1.
- Grifka, Chandler: Orthopedics trauma surgery . 9th edition. Springer 2013, ISBN 978-3-642-28875-3.
- Herold et al .: Internal Medicine . Self-published 2012, ISBN 978-3-981-46602-7.
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