Kyphosis
Kyphosis is normal in the thoracic spine (if less than 50 degrees), but is typically abnormal in the cervical and lumbar spines.
Examples of excess kyphosis in the thoracic spine include Scheueremann's kyphosis and Postural roundback. Scheueremann's kyphosis typically happens in teenage boys and is characterized by a short, sharp hunchback in the middle part of the upper spine. X-rays and an MRI help determine the degree of kyphosis and look for other causes of kyphosis.
Postural roundback is noted by a smooth, flexible kyphosis that is not typically associated with pain. The curve is easily corrected by asking the patient to stand up straight. Radiographically, the criteria for the diagnosis of postural roundback are kyphosis greater than 50 degrees, but without the other x-ray findings seen with Scheueremann's kyphosis. These curves tend to be mild and extend over a longer number of vertebral segments when compared to Scheueremann's kyphosis.
Post-traumatic or post-compression fracture kyphosis is also a common cause of this disease. Compression fractures typically occur secondary to trauma, tumor or osteoporosis. This condition may cause a focal kyphotic deformity and lead to pain. The deformity is corrected by various surgical techniques which offer improvement in pain and spinal balance. Correction of balance places the back muscles in a bio-mechanically advantageous position and helps reduce fatigue-related pain. Surgical techniques that our surgeons commonly employ include the pedicle subtraction osteotomy (see figure) [[please place figure 3 from powerpoint slides uploaded]] and Smith-Peterson osteotomy. These advanced surgeries require a lot of surgical skill and experience, but are some of the most rewarding surgeries for our patients.