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| | __NOTOC__ |
| | '''For patient information click [[{{PAGENAME}} (patient information)|here]]''' |
| {{DiseaseDisorder infobox | | | {{DiseaseDisorder infobox | |
| Name = Kyphosis | | | Name = Kyphosis | |
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| Caption = X-ray of a kyphosis of 70°| | | Caption = X-ray of a kyphosis of 70°| |
| ICD10 = {{ICD10|M|40|0|m|40}}-{{ICD10|M|40|2|m|40}}, {{ICD10|M|42|0|m|40}}, {{ICD10|Q|76|4|q|65}} | | | ICD10 = {{ICD10|M|40|0|m|40}}-{{ICD10|M|40|2|m|40}}, {{ICD10|M|42|0|m|40}}, {{ICD10|Q|76|4|q|65}} | |
| ICD9 = {{ICD9|732.0}}, {{ICD9|737.0}}, {{ICD9|737.1}} | | | ICD9 = {{ICD9|737.0}}, {{ICD9|737.1}} | |
| ICDO = | | | ICDO = | |
| OMIM = | | | OMIM = | |
| DiseasesDB = 21885 | | | DiseasesDB = 21885 | |
| MedlinePlus = | | | MedlinePlus = | |
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| }} | | }} |
| {{SI}} | | {{Kyphosis}} |
| {{EH}}
| | {{CMG}}; '''Associate Editor-In-Chief:''' {{CZ}} |
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| {{CMG}} | |
| __NOTOC__
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| '''Associate Editor-In-Chief:''' {{CZ}} | |
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| ==Overview==
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| '''Kyphosis''' (Greek - ''kyphos'', a hump), in general terms, is a curvature of the upper [[spine (anatomy)|spine]]. It can be either the result of bad posture or a structural anomaly in the spine.
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| Many [[radiologist]]s will detect kyphosis with a ''scolie'' or an ''AP-Lateral'' — two types of [[X-ray]]. A scolie ''(pictured to the right)'' is an X-ray taken from the rear. An AP-Lateral is taken from the side, where the X-ray machine is programmed to show the spine with high definition.
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| In the sense of a deformity, it is the pathological curving of the [[spine (anatomy)|spine]], where parts of the [[vertebral column|spinal]] column lose some or all of their lordotic profile. This causes a bowing of the [[back]], seen as a slouching posture. Symptoms of kyphosis, that may be present or not, depending on the type and extent of the deformity, include mild [[back pain]], [[Fatigue (physical)|fatigue]], appearance of round back and breathing difficulties. Severe cases can cause great discomfort and even lead to death.
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| ==Classification== | | ==[[Kyphosis overview|Overview]]== |
| There are several kinds of kyphosis ([[ICD|ICD-10]] codes are provided):
| | ==[[Kyphosis classification|Classification]]== |
| | ==[[Kyphosis pathophysiology|Pathophysiology]]== |
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| ===Postural kyphosis (M40.0)=== | | ==[[Kyphosis differential diagnosis|Differentiating Kyphosis from other Diseases]]== |
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| The most common type, normally attributed to slouching, can occur in both the old<ref>[http://taylorandfrancis.metapress.com/link.asp?id=m653630285934807 Annals of Human Biology], Volume 1, Number 3 / July 1974.</ref> and the young. In the young, it can be called 'slouching' and is reversible by correcting muscular imbalances. In the old, it may be called hyperkyphosis or dowager’s hump. About one third of cases have vertebral fractures.<ref name="pmid17785488">{{cite journal |author=Kado DM, Prenovost K, Crandall C |title=Narrative review: hyperkyphosis in older persons |journal=Ann. Intern. Med. |volume=147 |issue=5 |pages=330–8 |year=2007 |pmid=17785488 |doi=|url=http://www.annals.org/cgi/content/full/147/5/330}}</ref> Otherwise, the aging body tends towards a loss of musculoskeletal integrity<ref name="pmid12616157">{{cite journal |author=Keller TS, Harrison DE, Colloca CJ, Harrison DD, Janik TJ |title=Prediction of osteoporotic spinal deformity |journal=Spine |volume=28 |issue=5 |pages=455–62 |year=2003 |pmid=12616157 |doi=10.1097/01.BRS.0000048651.92777.30}}</ref>, and kyphosis can develop due to aging alone.<ref>[http://www.healthy.net/scr/article.asp?Id=1866 Osteopathy: A Complete Health Care System], by [http://www.healthy.net/scr/bio.asp?Id=54 Leon Chaitow N.D., D.O., M.R.O.]</ref><ref name="pmid17785488"/>
| | ==[[Kyphosis epidemiology and demographics|Epidemiology and Demographics]]== |
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| ===[[Scheuermann's disease|Scheuermann's kyphosis]] (M42.0)===
| | ==[[Kyphosis risk factors|Risk Factors]]== |
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| Scheuermann's kyphosis is significantly worse cosmetically and can cause pain. It is considered a form of juvenile [[osteochondrosis]] of the spine, and is more commonly called Scheuermann's disease. It is found mostly in teenagers and presents a significantly worse deformity than postural kyphosis. A patient suffering from Scheuermann’s kyphosis cannot consciously correct posture<ref>http://www.back.com/causes-developmental-scheuermann.html and http://www.emedicine.com/pmr/topic129.htm</ref>. The apex of the curve, located in the thoracic vertebrae, is quite rigid. The patient may feel pain at this apex, which can be aggravated by physical activity and by long periods of standing or sitting. This can have a significantly detrimental effect on their lives, as their level of activity is curbed by their condition; they may feel isolated or uneasy amongst peers if they are children, depending on the level of deformity. Whereas in postural kyphosis the vertebrae and disks appear normal, in Scheuermann’s kyphosis they are irregular, often herniated and wedge shaped over at least three adjacent levels. [[Fatigue (medical)|Fatigue]] is a very common symptom, most likely because of the intense muscle work that has to be put into standing and/or sitting properly. The condition seems to run in families.
| | ==[[Kyphosis natural history, complications and prognosis|Natural History, Complications and Prognosis]]== |
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| ===Congenital kyphosis (Q76.4)=== | | ==Diagnosis== |
| | [[Kyphosis history and symptoms|History and Symptoms]] | [[Kyphosis physical examination|Physical Examination]] | [[Kyphosis chest x ray|Chest X Ray]] | [[Kyphosis MRI|MRI]] |
| | ==Treatment== |
| | [[Kyphosis medical therapy|Medical Therapy]] | [[Kyphosis non surgical therapy|Non surgical Therapy]] | [[Kyphosis surgery|Surgery]] | [[Kyphosis primary prevention|Primary Prevention]] | [[Kyphosis cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Kyphosis future or investigational therapies|Future or Investigational Therapies]] |
| | ==Case Studies== |
| | :[[Kyphosis case study one|Case #1]] |
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| Congenital kyphosis can result in infants whose spinal column has not developed correctly in the womb. Vertebrae may be malformed or fused together and can cause further progressive kyphosis as the child develops. <ref>http://www.ejbjs.org/cgi/content/abstract/81/10/1367</ref>. Surgical treatment may be necessary at a very early stage and can help maintain a normal curve in coordination with consistent follow ups to monitor changes. However, the decision to carry out the procedure can be very difficult due to the potential risks to the child. A congenital kyphosis can also suddenly appear in teenage years, more commonly in children with cerebral palsy and other neurological disorders.
| | ==Related Chapters== |
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| ==Treatments== | |
| ===Physiotherapy===
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| * [[Physical therapy]]
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| * [[Chiropractic]]
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| Treatment for kyphosis may involve anti-inflammatory drugs as well as exercises to strengthen the [[Human abdomen|abdominal]] and [[hamstring]] muscles. John Albert Odom, Jr., M.D. states that;
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| ''While physical therapy (PT) doesn't help in severe cases of [[scoliosis]] and [[kyphosis]], it is still the mainstay of treatment for minor [[scoliosis]] and [[kyphosis]], The sooner physical therapy is started, the more likely the child will not end up with a humpback. We recommend that PT be started as early as age 10. At age 15 PT is considered too late to start, at this point bracing or surgery are the two most viable treatments especially if the curve is progressive and/or is accompanied by C-spine deformity.''<ref>[http://medicalreporter.health.org/tmr0795/scoliosis0795.html Spinal Deformities: Benefits of Early Screening and Treatment,] by John Albert Odom, Jr., M.D.</ref>
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| ===Orthosis (brace)===
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| Body braces showed benefit in a [[randomized controlled trial]].<ref name="pmid15043351">{{cite journal |author=Pfeifer M, Begerow B, Minne HW |title=Effects of a new spinal orthosis on posture, trunk strength, and quality of life in women with postmenopausal osteoporosis: a randomized trial |journal=American journal of physical medicine & rehabilitation / Association of Academic Physiatrists |volume=83 |issue=3 |pages=177–86 |year=2004 |pmid=15043351 |doi=}}</ref>
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| ===Surgery===
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| Surgical treatment can be used in severe cases. Surgical treatment also has greater risk involved than a brace, for example as in any surgery there is a risk of infection, which could be potentially serious in the current situation of multiple drug resistant bacteria such as [[MRSA]]. In patients with progressive kyphotic deformity due to vertebral collapse, a procedure called a [[kyphoplasty]] may arrest the deformity and relieve the pain. The procedure is serious and consists of fusion of the abnormal vertebrae<ref>http://www.spineuniversity.com/public/spinesub.asp?id=48</ref>.
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| ==References==
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| {{Reflist|2}}
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| ==See also ==
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| *[[Lordosis]] | | *[[Lordosis]] |
| *[[Kyphoscoliosis]] | | *[[Kyphoscoliosis]] |
| *[[Scoliosis]] | | *[[Scoliosis]] |
| *[[Pott's disease]] | | *[[Pott's disease]] |
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| == External links ==
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| * [http://www.spineuniverse.com/displayarticle.php/article1437.html Kyphosis: Description and Diagnosis]
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| *[http://www.scoliosissystems.com Kyphosis bracing]
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| * [http://orthoinfo.aaos.org/fact/thr_report.cfm?Thread_ID=247&topcategory=Spine Kyphosis (Curvature of the spine)]
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| * [http://www.spineuniverse.com/displayarticle.php/article593.html Scheuermann's Kyphosis (Scheuermann's Disease): Abnormal Curvature of the Spine]
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| * [http://www.efdeportes.com/efd81/hernia.htm Effects of a postural gymnastics programme on individuals with lumbar disk hernia]
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| * [http://www.spinecarefoundation.org/scheuermanns/genetic_studies.html Genetic Studies On Scheuermann's Disease]
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| {{Diseases of the musculoskeletal system and connective tissue}} | | {{Diseases of the musculoskeletal system and connective tissue}} |
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| [[Category:Skeletal system]] | | [[Category:Skeletal system]] |
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| [[Category:Orthopedics]] | | [[Category:Orthopedics]] |
| [[Category:Rheumatology]] | | [[Category:Rheumatology]] |
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| [[de:Kyphose]] | | [[de:Kyphose]] |
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| [[pt:Cifose]] | | [[pt:Cifose]] |
| [[fi:Kyfoosi]] | | [[fi:Kyfoosi]] |
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