Our spine team sees patients at these locations:
Mass General - Boston
55 Fruit Street
Yawkey Building, Suite 3A
Boston, MA 02114
Orthopaedics at Mass General Waltham
52 Second Avenue
Building 52, 1st Floor, Suite 1150
Waltham, MA 02451
Newton-Wellesley Spine Center
159 Wells Avenue
Newton, MA 02459
Mass General/North Shore Center for Outpatient Care
102-104 Endicott Street
Danvers, MA 01923
BW / Mass General Health Care Center
20 Patriot Place
Foxborough, MA 01923
What Is kyphosis?
A normal spine has some curvature to it, but a person afflicted with kyphosis has an exaggerated rounding of the back. When you view a normal spine from the side it appears straight, but a upper back of a person afflicted with kyphosis will appear curved.
Types of kyphosis
- Postural kyphosis:The most common type of kyphosis, it is often associated with slouching. Typically it is first noticed during adolescence, and it affects girls more than boys. It usually does not cause pain. While exercise can help to strengthen and stretch muscles, exercise most likely will not have a significant effect of the spine curvature. Most children affected by postural kyphosis will not have complications in their adult life from it.
- Scheuermann’s kyphosis:This type of kyphosis also is first noticed during adolescence and happens while an adolescent is still growing. It typically affects boys more than girls. In Scheuermann’s kyphosis, the vertebrae, which normally are rectangular in shape, become wedged together and triangular in shape. It causes the vertebrae to curve forward in the upper back because the vertebrae did not grow correctly – the front part of the vertebrae did not grow as well as the back part of the vertebrae. The cause of Scheuermann’s kyphosis is not known.
- Congenital kyphosis:This is the least common type of kyphosis. It is caused by abnormal development, which causes the vertebrae to fuse together.
- Age-related kyphosis:Age-related kyphosis is the most common type of kyphosis in adults and tends to affect women more than men. It often occurs because osteoporosis weakens spinal bones and makes them more susceptible to fracture.
To diagnose kyphosis, your doctor will take a detailed medical history finding out when the discomfort started and perform a thorough physical evaluation. Your doctor most likely will request a x-ray, MRI scan or CT scan to see how your vertebrae look.
For postural kyphosis, typically treatment involves physical therapy to strengthen the back muscles and correct poor posture. Your doctor may have you wear a back brace and may recommend anti-inflammatory medication like ibuprofen or naproxen.
For Scheuermann’s kyphosis, bracing is commonly used, but it is only effective in changing the curvature of the spine if the patient is still growing. Bracing can be use for older patients who suffer from Scheuermann’s kyphosis, but this is to relieve pain and discomfort, not correct the curvature. Surgery is only effective if the curvature exceeds 75 degrees when measured on an x-ray. Surgery usually involves a spinal fusion of the abnormal vertebrae.
For congenital kyphosis, treatment options vary on the severity. Most doctors will observe the child over several visits to monitor the progression of the curvature. Severe congenital kyphosis that measures greater than 45 degrees or kyphosis that is associated with neurological weakness is usually treated surgically. Early surgical intervention can stop the progression of the curve.
Treatment for age-related kyphosis usually starts with dealing with the underlying osteoporosis to prevent future fractures. Your doctor will monitor your progress over several visits to track the change in curvature, and for most patients, treating the osteoporosis as well using pain reduction techniques, surgery is not necessary.