The spine consists of three parts. When viewed from the side, these sections are arranged in such a way as to form three natural curves. The "c-shaped" curves of the neck (cervical spine) and lower back (lumbar spine) are called lordosis. The "inverted c-shaped" curve of the chest (thoracic spine) is called kyphosis. This natural curvature of the spine is important for balance and helps a person to stand upright. If any of the curves become too large or too small, it becomes difficult to stand upright and the posture looks abnormal.
While the thoracic spine should have a natural angle of 20 to 45 degrees, due to postural or structural abnormalities, a curvature outside the normal range may occur. Decapitation of the thoracic spine Larger than normal (more than 50 degrees of curvature is actually the medical term for "hiperkifoz called" although, "kyphosis" the term is usually very excessive curvature of the thoracic spine by doctors is used to refer to the state to create a curved upper back.
Kyphosis can affect patients of any age. However, this condition is more common during adolescence, when there is rapid bone growth.
The severity of kyphosis can vary. In general, the larger the curve, the more serious the situation. Lighter curves may cause mild back pain or show no symptoms at all. More severe curves, on the other hand, can cause significant spinal deformity and cause a visible hump on the patient's back.
What are the types of kyphosis?
There are many types of kyphosis and their causes. The three kyphoses that most affect children and adolescents can be listed as follows.
* Postural kyphosis
* Scheuermann's kyphosis
* Congenital (Congenital) kyphosis
Postural kyphosis, the most common type of kyphosis, usually becomes pronounced during puberty. It is clinically noticeable as poor posture or slouching posture. But serious structural abnormalities of the spine are not observed very much. The curvature caused by postural kyphosis is typically rounded and smooth. In addition, the curvature can often be corrected by the patient, when he is asked to "stand upright". Postural kyphosis in girls is more common than in boys. It is rarely painful and may not cause problems in adult life because the curve does not progress.
THE JOINT SCHEUERMANN
Scheuermann kyphosis is named after the Danish radiologist who first described the condition. Like postural kyphosis, Scheuermann's kyphosis usually becomes apparent in the teenage years. However, Scheuermann's kyphosis can cause a significantly more severe deformity than postural kyphosis, especially in weak patients. Scheuermann kyphosis is caused by a structural abnormality in the spine. In a patient with Scheuermann kyphosis, an X-ray from the side will show that several consecutive vertebrae have a more triangular shape instead of the usual rectangular shape. The curvature caused by Scheuermann kyphosis is usually sharp and angled. Unlike a patient with postural kyphosis, a patient with Scheuermann kyphosis cannot correct the curve by standing upright.
Scheuermann's kyphosis usually affects the thoracic spine. But sometimes it develops in the lumbar (lower) spine. The condition is more common in boys than girls, and its progression stops when growth is complete. Scheuermann's kyphosis can sometimes be painful. If there is pain, it is usually felt at the highest part of the curve or at the "peak". Pain can also be felt in the lower back. Actions such as activity, standing or sitting for a long time can make the pain worse.
This type of kyphosis is present at birth. It occurs when the spine does not develop normally while the baby is in the womb. The bones may not form as they should, or several vertebrae may be fused together. Congenital kyphosis typically worsens as the child ages.
Patients with congenital kyphosis often need surgical intervention at a very young age to stop the progression of curvature. Often, these patients have October birth defects that affect other parts of the body, such as the heart and kidneys.
What are the symptoms of kyphosis?
The signs and symptoms of kyphosis vary depending on the cause and severity of the curvature. They can be sorted as follows:
* Rounded shoulders
• A visible hump on the back
* Mild back pain
* Spinal stiffness
* Tight beams (muscles on the back of the thigh)
Rarely, hunchback that progresses over time can lead to:
* Weakness, numbness or tingling in the legs
* Loss of sensation
* Shortness of breath or other breathing difficulties
Apart from the types of kyphosis mentioned above, abnormal curvature can also be caused by the following:
* Fractures: Broken or crushed vertebrae (compression fractures) can cause curvature of the spine. Mild compression fractures usually do not produce noticeable signs or symptoms.
* Osteoporosis: It is a condition of decreased bone density, which is observed especially with old age. Especially if the weakened vertebrae end up with compression fractures, it can cause spinal curvature. Osteoporosis is most common in older women and people who have taken corticosteroids for a long time.
* Disc degeneration: Soft, circular discs act as a cushion between the vertebrae Decapitated. With age, these discs dry out and shrink, which often worsens kyphosis.
* Syndromes: Kyphosis in children can also be associated with certain syndromes, such as Ehlers-Danlos syndrome and Marfan syndrome.
• Cancer and cancer treatments: Factors such as cancer in the spine, chemotherapy and radiation treatments can weaken the vertebrae and make them more prone to compression fractures.
How is kyphosis diagnosed?
The Doctor's Examination
Mild kyphosis is usually not noticed until scoliosis screening is performed at school. If the changes in the patient's back are noticeable enough to be noticed, this is usually quite uncomfortable for both parents and the child. Concerns about the cosmetic appearance of the child's back are often what pushes the family to seek medical help.
The doctor takes a medical history and begins by asking questions about the individual's general health and symptoms. He then examines the back, pressing on the spine to determine if there are any areas of sensitivity. In more severe cases of kyphosis, a rounding of the upper back or a hump is clearly visible. But in milder cases, the condition may be more difficult to diagnose.
During the examination, the doctor asks the patient to lean forward with both feet adjacent, knees straight and arms free. This test, called the "Adam's forward bending test", allows the doctor to better see the tilt of the spine and observe any spinal deformities.
Your doctor may also ask the patient to lie down to see if he has corrected the curve. This condition is a sign that the curve is flexible and may be representative of postural kyphosis.
* X-ray: If the doctor deems it necessary, he may order an X-ray from different angles to determine whether there are changes in the vertebrae or any other bone abnormalities. X-rays will also help to measure the degree of the kyphotic curve. a curve greater than 50 degrees is considered abnormal.
* Pulmonary function tests: If the kyphosis is very severe, the doctor may order pulmonary function tests. These tests will help determine whether the patient's breathing is restricted due to a decrease in the chest cavity.
• Other tests: In patients with congenital kyphosis, progressive hunchback can lead to symptoms of spinal cord compression, including pain, tingling, numbness, or weakness in the lower part of the body. If the patient is experiencing any of these symptoms, the doctor may order neurological tests or a magnetic resonance imaging (MRI) scan.
How to treat kyphosis?
The goal of treatment is to stop the progression of curvature and prevent deformity. When determining the treatment for kyphosis, the doctor will take into account several things, including:
* The patient's age and general health
* Number of remaining growth years
* Type of kyphosis
* The intensity of the curve
Non-surgical treatment is recommended in patients with postural kyphosis. In addition, these treatment options are also recommended for patients with Scheuermann kyphosis who have curves of less than 75 degrees.
Non-surgical treatment may include:
* Observation: The doctor may recommend monitoring the curvature to make sure the problem does not get worse. In particular, when kyphosis is observed in a child patient, periodic visits and x-rays may be desirable until he grows up completely. No further treatment may be necessary unless the curve worsens or becomes painful.
* Physical Therapy: Specific kyphosis exercises can help relieve back pain and improve posture by strengthening the muscles in the abdomen and back
* Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs, including aspirin, ibuprofen, and naproxen, can help relieve back pain.
* Support: A kyphosis corset may be recommended for patients with Scheuermann's kyphosis who are still growing. The specific type of corset and the number of hours per day it needs to be worn will depend on the severity of the curve. As the curvature heals, the doctor adjusts the corset regularly. Typically, corsets are worn until the child reaches skeletal maturity and his growth is complete.
Surgery is usually recommended for patients with congenital kyphosis. In addition, surgery may also be recommended for the following conditions:
* patients with Scheuermann kyphosis with curves of more than 75 degrees
* Patients with severe low back pain that does not improve with non-surgical treatment
Spinal fusion is the most commonly used surgical procedure to treat kyphosis.
Objectives of spinal fusion:
* Reducing the degree of curvature
* Prevent further progress
* To be able to maintain development over time
* Relieve significant back pain, if any
Spinal fusion is essentially a "welding" process. The basic idea is to combine the affected vertebrae in such a way that they turn into a single, solid bone. Fusing the spine Decays the degree of curvature and can also relieve back pain, as it eliminates movement between the affected vertebrae.