Kyphosis or a partially “hunched” back is normal in the thoracic spine. If you look at someones’s profile, you will notice that there is a curve in the upper back and a curve in the lower spine Moderate kyphosis is normal which is between 20 -50 degrees. Anything beyond 50 degrees is considered abnormal.
An untrained person cannot determine abnormal kyphosis without testing which is usuallly done with x-ray and can determine the degree of hunch and balance of the spine.
There are two common forms of kyphosis encountered in the teenage population: 1. postural roundback and 2. Scheueremann's kyphosis
Postural roundback is noted by a subtle, flexible kyphosis and there is usually no pain. The curve is easily corrected by asking the child to stand up straight. These curves tend to be mild in severity and extend over a longer number of vertebral segments when compared to Scheueremann's kyphosis.
Scheueremann's kyphosis is most common in teenage boys. It is characterized by a short, intense kyphosis in the middle part of the upper spine, sometimes associate with back pain. Sometimes scoliosis will also be present with Scheueremann's kyphosis.
Kyphosis treatment methods depend on the degree of deformity, age of patient, the risk of progression, and the number of symptoms. Treatments include observation, bracing and in extreme cases surgery. Kyphosis below 50 degrees usually requires no treatment. Braces are typically used in patients with kyphosis of 50 and 75 degrees. Kyphosis bracing is technically difficult but can produce sustainable correction if worn consistently during growth.
Surgery is usually reserved for kyphosis curves greater than 75 degrees or there is progressive loss of bone. Surgical treatments correct the spinal deformity using special instrumentation and fusion of the spine. The aim is also to prevent recurrence later in life.