KYPHOSIS

SPINAL
COLUMN
Deformitie
Kyphosis
AKA
• Scheurmann’s disease;
• Roundback;
• Hunch back; Postural kyphosis
Kyphosis
Is a curving of the spine that causes a
bowing or rounding of the back, which
leads to a hunchback or slouching posture.
A PICTURE
ALWAYS
REINFORCES
THE CONCEPT
Causes, incidence, and risk
factors
● Kyphosis can occur at any age, although it is rare at birth.

● Adolescent kyphosis, also known as Scheuermann's disease, is caused
by the wedging together of several bones of the spine (vertebrae) in a
row. The cause of Scheuermann's disease is unknown.
● In adults, kyphosis can be caused by:
○Degenerative diseases of the spine (such as arthritis or disk degeneration)
○Fractures caused by osteoporosis (osteoporotic compression fractures)
○Injury (trauma)
○Slipping of one vertebra forward on another (spondylolisthesis )
Other causes of Kyphosis include:
• Certain endocrine diseases

• Connective tissue disorders
• Infection (such as tuberculosis)
• Muscular dystrophy
• Neurofibromatosis
• Paget's disease
• Polio
• Spina bifida
• Tumors/Cancer
• Apixaban
• Cervical spondylosis
• Spina bifida
Congenital Kyphosis
• Congenital kyphosis is caused when

something disrupts the normal development
of the spine before birth. In many cases, two
or more of the vertebrae fuse together.Clinical
photograph and MRI scan of a child with an
abrupt congenital kyphosis in the thoracic
spine. The MRI scan shows a posteriorly
located hemivertebra causing impingement
on the spinal cord. (Courtesy of Texas
Scottish Rite Hospital for Children)
Postural Kyphosis
• Poor posture in childhood, such as

slouching, leaning back in chairs and
carrying heavy schoolbags, can cause
the ligaments and muscles that
support the vertebrae to stretch. This
can pull the thoracic vertebrae out of
their normal position, resulting in
kyphosis.
Scheuermann's kyphosis (Abnormally shaped vertebrae)
• Kyphosis can also be caused

when the vertebrae don't
develop correctly. They can take
on a wedged, triangular shape,
rather than the normal
rectangular, box-like shape.
This leads to the vertebrae
being out of position and is
known as Scheuermann's
kyphosis.
Kyphosis can also be seen with scoliosis. Each
cause has its own risk factors.
Sypmtoms
● Difficulty breathing (in severe

cases)
● Fatigue
● Mild back pain
● Round back appearance
● Tenderness and stiffness in
the spine
Diagnostic Exams
● Physical examination by a
health care provider confirms
the abnormal curve of the
spine.
● The doctor will also look for any
nervous system (neurological)
changes (weakness, paralysis,
or changes in sensation) below
the curve.
Treatment
Treatment depends on the cause of the disorder:

● Congenital kyphosis requires corrective surgery at an
early age.
● Scheuermann's disease is treated with a brace and
physical therapy. Occasionally surgery is needed for
large (greater than 60 degrees), painful curves.
Treatment
Treatment depends on the cause of the disorder:

• Multiple compression fractures from osteoporosis can be left
alone if there are no nervous system problems or pain. However,
the osteoporosis needs to be treated to help prevent future
fractures. For debilitating deformity or pain, surgery is an option.
• Kyphosis caused by infection or tumor needs to be treated more
aggressively, often with surgery and medications.
• Treatment for other types of kyphosis depends on the cause.
Surgery may be necessary if neurological symptoms or persistent
pain develop.
Expectations (prognosis)
● Adolescents with Scheuermann's disease tend to do well

even if they need surgery, and the disease stops once they
stop growing.
● If the kyphosis is due to degenerative joint disease or
multiple compression fractures, surgery is needed to
correct the defect and improve pain.
Complications
● Decreased lung capacity

● Disabling back pain
● Neurological symptoms
including leg weakness or
paralysis
● Round back deformity
Prevention
● Treating and preventing osteoporosis can

prevent many cases of kyphosis in the
elderly.
● Early diagnosis and bracing of
Scheuermann's disease can reduce the
need for surgery, but there is no way to
prevent the disease.
NURSING RESPONSIBILITIES
● Continually assess motor function by requesting patient to perform certain actions like shrugging shoulders.
● Encourage the patient to avoid slouching. Follow certain habits like maintaining good posture, good diet, and
exercise.
● Assess client’s description of pain including the type, location, and intensity.
● Instruct with the use of nonpharmacologic pain management techniques, such as imagery, relaxation, touch, music.
● Encourage regular postural exercises.
● Encourage patient to intake enough calcium and vitamin D to maintain bone strength.
● Assist the patient with full range of motion exercises in all extremities and joints using slow, smooth movements.
● Plan activities to provide uninterrupted rest periods. Encourage involvement within individual tolerance or ability.
● Encourage use of relaxation techniques.
● Inspect skin daily. Observe for pressure areas and provide meticulous care.
● Periodical weight check- up and adequate intake of calcium in diet can reduce the risk of osteoporosis and spine
fractures that can cause kyphosis.
● Consult with a physical therapist for collaborative care as indicated.

KYPHOSIS

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SPINAL

● Kyphosis can occur at any age, although it is rare at birth.

• Certain endocrine diseases

• Congenital kyphosis is caused when

• Poor posture in childhood, such as

• Kyphosis can also be caused

● Difficulty breathing (in severe

Treatment depends on the cause of the disorder:

Treatment depends on the cause of the disorder:

● Adolescents with Scheuermann's disease tend to do well

● Decreased lung capacity

● Treating and preventing osteoporosis can

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