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.
MRI (if there may be a tumor, infection, or neurological symptoms)
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.
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.
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.
Decreased lung capacity
Disabling back pain
Neurological symptoms including leg weakness or paralysis
Round back deformity
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.
Spiegel DA, Hosalkar HS, Dormans JP. The spine. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 678.
Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.