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Kyphosis Surgery

Dr. Arvind Jayaswal (HOD)

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Kyphosis is a forward rounding of the back. Some rounding is normal, but the term “kyphosis” usually refers to an exaggerated rounding of the back. While kyphosis can occur at any age, it’s most common in older women. Age-related kyphosis often occurs after osteoporosis weakens spinal bones to the point that they crack and compress. Other types of kyphosis are seen in infants ,kids or teens due to malformation of the spine or wedging of the spinal bones over time.

Mild kyphosis causes few problems, but severe cases can cause pain and be disfiguring. Treatment for kyphosis depends on your age, the cause of the curvature and its effects.

The individual bones (vertebrae) that make up a healthy spine look like cylinders stacked in a column. Kyphosis occurs when the vertebrae in the upper back become more wedge-shaped. This deformity can be caused by a variety of problems, including:

  • Osteoporosis. This bone-thinning disorder can result in crushed vertebrae (compression fractures). Osteoporosis is most common in older adults, particularly women, and in people who have taken high doses of corticosteroids for long periods of time.
  • Disk degeneration. Soft, circular disks act as cushions between spinal vertebrae. With age, these disks dry out and shrink, which often worsens kyphosis.
  • Scheuermann’s disease. Also called Scheuermann’s kyphosis, this disease typically begins during the growth spurt that occurs before puberty. Boys are affected more often than are girls. The rounding of the back may worsen as the child finishes growing.
  • Birth defects. If a baby’s spinal column doesn’t develop properly in the womb, the spinal bones may not form properly, causing kyphosis in small children
  • Syndromes. Kyphosis in children can also be associated with certain syndromes, such as Marfan syndrome or Prader-Willi disease.
  • Cancer and cancer treatments. Cancer in the spine can weaken vertebrae and make them more prone to compression fractures, as can chemotherapy and radiation cancer treatments.

An increased curve in the upper spine also can be caused by slouching. Called postural kyphosis, this condition doesn’t involve any deformities in the spine. It’s most common in teenagers.

If you have mild to moderate kyphosis, it may be possible to control your symptoms using painkillers and exercise.

Painkillers and exercise

Over-the-counter painkillers, such as ibuprofen or paracetamol, can help relieve any back pain. Regular exercise and a course of physiotherapy may be recommended to help strengthen the muscles in your back.

Back pain can also be helped by maintaining a healthy weight and activities which strengthen core muscles. For example, yoga, pilates or some martial arts.

Bracing

Teenagers with mild to moderate kyphosis may need to wear a back brace. The brace is worn while the bones are still growing and prevents the curve getting worse.

Wearing a brace may feel restrictive at first. However, most people get used to them after a while. Modern braces are designed to be convenient, so it should still be possible to take part in a wide range of physical activities.

You’ll need to wear the brace until the spine stops growing, which is usually around 14 or 15 years of age

Bracing isn’t usually recommended for adults who have stopped growing because it won’t correct the position of the spine.

Surgery

Surgery can usually correct the appearance of the back and may help to relieve pain but it carries quite a high risk of complications.

Surgery is only recommended for more severe cases of kyphosis, where it’s felt the potential benefits of surgery outweigh the risks.

Surgery for kyphosis would usually be recommended if:

  • the curve of your spine is very pronounced
  • the curve is causing persistent pain that can’t be controlled with medication
  • the curve is disrupting your body’s other important functions, such as breathing and the nervous system
  • without surgery it’s likely that the structure of your spine would deteriorate further

A technique called spinal fusion is usually used to treat kyphosis. It involves joining together the vertebrae responsible for the curve of the spine.

During the operation, an incision is made in your back. The curve in your spine is straightened using metal rods, screws and hooks, and your spine is fused into place using bone grafts

Duration: The procedure takes 4 to 8 hours and is carried out under general anaesthetic and spinal cord monitoring is mandatory

Recovery: You may need to stay in hospital for up to a week after the operation, and you may have to wear a back brace for up to 9 months to support your spine while it heals. You should be able to return to school, college or work after 4 to 6 weeks, and be able to play sports about a year after surgery.

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