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KYPHOSIS SURGERY IN INDIA

What Is Kyphosis?

The spine has a series of normal curves when viewed from the side. These curves help to better absorb the loads applied to the spine from the weight of the body. The cervical spine (neck) and lumbar spine (lower back) are have a normal inward curvature that is medically referred to as lordosis or “lordotic” curvature by which the spine is bent backward. The thoracic spine (upper back) has a normal outward curvature that is medically referred to as kyphosis or the “kyphotic” curve by which the spine is bent forward.

The spine is normally straight when looking from the front. An abnormal curve when viewed from the front is called scoliosis. Scoliosis can occur from design at birth or from rotation or an abnormal twisting of the vertebrae as from pain.

The normal curves of the spine allow the head to be balanced directly over the pelvis. If one or more of these curves is either too great or too small, the head may not be properly balanced over the pelvis. This can lead to back pain, stiffness, and an altered gait or walking pattern.

What causes kyphosis?

Kyphosis can be congenital (present at birth), or due to acquired conditions that may include the following: –

• metabolic problems
• neuromuscular conditions
• osteogenesis imperfecta – also called “brittle bone disease.” A condition that causes bones to fracture with minimal force.
• spina bifida
• Scheuermann’s disease – a condition that causes the vertebrae to curve forward in the upper back area. The cause of Scheuermann’s disease is unknown and is commonly seen in males.

Kyphosis is more common in females than males.

What Are The Symptoms Of Kyphosis?

The most common symptoms for patients with an abnormal kyphosis are the appearance of poor posture with a hump appearance of the back or “hunchback,” back pain, muscle fatigue, and stiffness in the back. Most often, these symptoms remain fairly constant and do not become progressively worse with time.

In more severe situations, the patient may notice their symptoms worsening with time. The kyphosis can progress, causing a more exaggerated hunchback. In rare cases, this can lead to compression of the spinal cord with neurologic symptoms including weakness, loss of sensation, or loss of bowel and bladder control. Severe cases of thoracic kyphosis can also limit the amount of space in the chest and cause cardiac and pulmonary problems leading to chest pain and shortness of breath.

How Is Kyphosis Diagnosed?

The physician makes the diagnosis of kyphosis with a complete medical history, physical examination, and diagnostic tests. If the patient is a child, the physician obtains a complete prenatal and birth history of him/her and asks if other family members are known to have kyphosis. The physician also will ask about developmental milestones since some types of kyphosis can be associated with other neuromuscular disorders. Developmental delays may require further medical evaluation.

Diagnostic procedures may include the following: –

• X-rays – a diagnostic test which uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. This test is used to measure and evaluate the curve. With the use of a full-spine x-ray, the physician or radiologist measures the angle of the spinal curve. A determination for treatment can often be made based on this measurement.

 

• Radionuclide Bone Scan – a nuclear imaging technique that uses a very small amount of radioactive material, which is injected into the patient’s bloodstream to be detected by a scanner. This test shows blood flow to the bone and cell activity within the bone.

 

• Magnetic Resonance Imaging (MRI) – a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. This test is done to rule out any associated abnormalities of the spinal cord and nerves.

 

• Computed Tomography Scan (Also called a CT or CAT scan.) – a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.

 

• Blood Tests – Early detection of kyphosis is important for successful treatment. Pediatricians or family physicians, and even some school programs, routinely look for signs that kyphosis may be present.

How Is Abnormal Kyphosis Treated?

Postural kyphosis can usually be treated with physical therapy to help strengthen the muscles of your back and correct your posture. Mild pain relievers and antiinflammatory medications can also help with symptoms. These curves do not continue to worsen with time or lead to more serious complications. Surgery is not needed for postural kyphosis.

Scheuermann’s kyphosis is usually initially treated with a combination of physical-therapy exercises and mild pain and antiinflammatory medications. If the patient is still growing, a brace can be effective. Braces are often recommended for curves of at least 45 degrees and can be continued until the patient is no longer growing. Your physician will likely obtain routine X-rays to monitor the degree of kyphosis over time. Bracing is not typically recommended for adults who are no longer growing.

In some cases, surgery is recommended for Scheuermann’s kyphosis. The goals of surgery are to partially correct the deformity of the kyphosis, relieve pain, and improve your overall spinal alignment. Indications for surgery include a curve greater than 75 degrees, uncontrolled pain, and neurologic, cardiac, or pulmonary complaints.

There are various types of surgical procedures available depending on the specifics of each case. Surgery can be performed from the front (anterior approach), from the back (posterior approach), or both (combined anterior and posterior approach). This decision is made by your surgeon based on the specific characteristics of your curve. You may obtain X-rays bending forward and backward to determine how flexible your spine is. If it is flexible, a posterior approach may be adequate. If you are less flexible, you may need an anterior or combined approach. Regardless of the approach, the surgery involves partially straightening your spine and using rods and screws in the vertebrae to hold the spine while a bony fusion occurs.

Treatment of congenital kyphosis often involves surgery while the patient is an infant. This is because the kyphosis is caused by an abnormality in the developing vertebrae. Surgery earlier in life can help correct the kyphosis before it continues to worsen.

Sometimes kyphosis from painful collapse of vertebrae due to osteoporosis is treated with a procedure called a kyphoplasty, whereby a balloon is inserted into the affected vertebra and filled with a liquid (methymethacrylate) that hardens to restore the vertebral height.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_message style=”square” message_box_color=”mulled_wine”]

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