Kyphosis Surgery

What is Kyphosis (Hunchback)?

Kyphosis is a condition in which the upper part of the spine bends abnormally outward, creating an increased curvature. This curvature usually affects the thoracic region of the spine (thoracic spine), causing a visually striking hunchback appearance. The human spine essentially consists of three main parts:

• The cervical (neck) spine is the center of our head and neck movements and consists of seven vertebrae.
• The thoracic (chest) spine consists of 12 vertebrae that support the rib cage and form the upper back.
• The lumbar spine is located in the lower back and consists of five vertebrae.

Each spinal segment has its own unique curve. In a healthy spine, these curves support the body’s movement and posture by providing a balanced load distribution. While the curves in the neck (cervical) and waist (lumbar) regions turn inward (lordosis), there is a slight outward curve (kyphosis) in the back (thoracic) region. Under normal conditions, the kyphosis angle of the thoracic region varies between 20 and 45 degrees.

In the case of kyphosis, this natural curve can become excessive and reach an angle greater than 45 degrees, causing the shoulders to droop forward and a pronounced hunchback in the upper back. Kyphosis can be caused by a variety of factors; Congenital structural abnormalities, age-related changes, osteoporosis, poor posture or spine diseases can be counted among these factors. The severity and treatment of kyphosis varies from person to person and depends on the cause of the condition. While some mild cases can be corrected with exercise and posture therapy, more serious cases may require surgical intervention.

What are the Types of Kyphosis?

Kyphosis, commonly known as hunchback, is the name given to the excessive curvature in the thoracic region of the spine and although it can be seen in all age groups, it is more common among young people and older women. The main causes of kyphosis observed in children and teenagers are:

Postural Kyphosis: It usually occurs during adolescence and is a result of poor posture habits. This type of hunchback can usually be corrected with simple interventions; For example, correcting posture and doing special exercises can help young people recover from this condition. It is mostly painless and does not cause serious complications in adulthood.

Scheuermann’s Kyphosis: Named after the Danish doctor who described this disorder, Scheuermann’s disease is a developmental condition that usually occurs in adolescence and causes the spine to curve abnormally. It is more severe than postural kyphosis, can cause symptoms such as back pain, and sometimes requires surgical intervention.

Congenital Kyphosis: It is a condition that occurs when the spine does not develop properly before birth and usually requires surgical intervention. This type of kyphosis often gets worse as the child develops and can lead to serious complications.

The severity of kyphosis and the area it affects vary greatly depending on individual factors. When kyphosis is more severe, complications such as back pain and pressure on the respiratory or cardiovascular system can develop. The greater the angle of the hunchback, the greater the symptoms and health problems caused by this condition. Especially when the curvature exceeds 75 degrees and tends to progress, surgical intervention may be the most appropriate treatment method. In addition to surgery, physiotherapy, special exercise programs and posture correcting devices are also among the treatment methods and are tailored to individual needs.

What are the symptoms of Kyphosis (Hunchback)?

Kyphosis, also known as hunchback, occurs when the spine curves more than its natural curvature, and in some cases, individuals may not show any symptoms. However, it may be accompanied by certain symptoms and signs that indicate the presence of this condition. The symptoms that kyphosis may cause can be listed as follows:

Back Pain and Stiffness: Pain and limited movement in the upper back are the most common symptoms. The pain may be constant or intermittent and is often exacerbated after standing or sitting for long periods of time.

Tender Points on the Spine: Tenderness or pain may be felt when pressure is applied in places where there is kyphotic curvature.

Differences in Shoulder Level: One shoulder may be higher than the other, which can lead to an asymmetrical shoulder line and poor posture.

Appearance Changes When Bending: When a person bends forward, the curvature in the upper back is likely to become more pronounced.

Difficulty in Head and Neck Movements: The severity of kyphosis can affect the natural position of the head and cause difficulty in looking forward or upward.

In more severe cases of kyphosis, more serious symptoms may occur:

Shortness of Breath and Breathing Problems: The curvature can put pressure on the rib cage, preventing the lungs from expanding, which can cause breathing difficulties.

Fatigue: The body spends more energy balancing the curvature, which can lead to rapid fatigue.

Digestive Problems: Severe kyphosis can put pressure on the digestive system, making the process of eating difficult.

What Causes Hunching?

Hunching, or kyphosis as it is medically known, is a condition in which the spine has a curvature above normal and can occur due to various factors. Although genetic predisposition and developmental disorders form the basis of this condition, lifestyle and health conditions may also be effective in the development of kyphosis.

The main reasons that cause excessive humpback in the spine can be listed as follows:

• • Long-term poor posture habits can distort the shape of the spine and pave the way for the development of kyphosis.
    Scheuermann Disease: This condition, seen in young people, is a structural disorder characterized by the front part of the spinal bones growing slower than the back part.
  • As we age, the spinal bones weaken and lose flexibility, which can cause the spine to bend forward.
  • As bone density decreases, collapse of the back vertebrae may occur, causing a hunchback.
  • Serious injuries or fractures can disrupt the natural structure of the spine and contribute to the development of kyphosis.
  • Some infections affecting the spine, especially infections affecting bone such as tuberculosis, can cause deformation in the spine.
  • Some treatment methods for tumors or cancer in the spine may cause changes in the structure of the spine.
  • Metabolic diseases that affect the development and health of bones can contribute to the formation of a hunchback.
  • Dysfunction of muscles and nerves can cause difficulties in supporting the spine, which can trigger the formation of curvatures.
  • Congenital spine problems such as spina bifida can also increase the risk of developing kyphosis.

Each of these factors can affect the anatomical structure of the spine and play a role in the formation of kyphosis. If you suspect hunchback, you can benefit from early diagnosis and treatment opportunities by consulting a spine specialist. Experts will prepare the most appropriate treatment plan for you to protect your spine health and prevent potential complications.

How is Kyphosis Diagnosed?

To diagnose kyphosis, the physician begins with a comprehensive interview with the patient and obtains detailed information about his or her medical history. During the physical examination, the patient’s posture, spinal curvature and movement capacity are evaluated. When the patient relaxes his shoulders and leans forward, the doctor can measure the severity of the curvature and humpback in the spine.

After physical evaluation, imaging tests may be required to make a more specific diagnosis and determine the extent of the curve. These tests include:

X-rays: They show the structural details of the spine and the degree of curvature, and are used to detect possible bone abnormalities or fractures.
Magnetic Resonance Imaging (MRI): Provides a detailed image of the spine and surrounding soft tissues, and is important to evaluate the effects on nerve roots and spinal cord.
Computed Tomography (CT): Unlike MRI, CT provides a more detailed image of bone structure and is especially preferred to examine complex anatomical structures and deformations.

If the patient exhibits neurological symptoms, Electromyography (EMG) test may be performed to evaluate nerve functions. This test determines the presence and level of nerve damage and muscle weakness.

Additional tests may be performed to understand the underlying causes of kyphosis, especially in elderly patients. For example, bone density tests (such as a DEXA scan) can be used to detect osteoporosis; Blood tests may be required to check for the presence of infection or other systemic diseases.

How is Kyphosis (Hunchback) Treated?

Treatment of kyphosis (hunchback) varies depending on the degree of spinal curvature, age, underlying causes and accompanying symptoms. Treatment usually begins with more protective and supportive methods in mild cases. In more severe and advanced cases, more aggressive and surgical methods may be used.

Treatments for patients with mild or moderate kyphosis include:

Physical Therapy: The patient can correct his posture and strengthen his back and trunk muscles with special exercises. This treatment can also relieve pain and promote better posture by increasing spinal flexibility.

Corset: The use of a corset is recommended in cases seen in children in adolescence and who still have growth potential. A brace can help prevent the progression of spinal curvature. However, corsets are generally not effective in adult patients with completed bone development.

Pain Management: Painkillers recommended by the doctor can be used for mild and manageable back pain.

In severe cases of kyphosis, treatment may include the following options:

Surgical Intervention: If the spinal curvature is severe and affects vital functions (such as respiratory distress) or does not respond to conservative treatment methods, surgical treatment may be considered. Spinal fusion may be performed to straighten and stabilize the spine.

Osteoporosis Treatment: If the cause of kyphosis in adult and elderly patients is often osteoporosis, this condition should be treated to increase bone density and prevent bone fractures.

Each treatment plan must be customized to suit the individual situation and requires regular medical monitoring. During the kyphosis treatment process, a multidisciplinary approach is important to improve the quality of life of patients and protect their spine health. During this process, patients’ compliance with treatment and regular exercise are critical for the effectiveness of the treatment.

Kyphosis Surgery

Kyphosis, commonly known as hunchback, is characterized by abnormal outward bending of the spine. Surgical intervention may be necessary in cases of kyphosis that extends beyond a certain angle and causes complications such as severe pain, breathing difficulties or neurological problems.

In Which Situations Is Kyphosis Surgery Necessary?

• If the spinal curvature has an angle of 75 degrees or higher
• If severe back pain cannot be controlled with medication
• If you have difficulty breathing due to curvature
• If neurological symptoms related to the nervous system are observed
• If other treatment methods have failed and the spinal curvature continues to progress

Goals of Kyphosis Surgery:

• Correcting spinal curvature
• Reduce or eliminate back pain
• Improving the patient’s overall posture and appearance
• Improving breathing and neurological functions

Surgical Techniques and Methods:

Spinal fusion is a frequently used method in the surgical treatment of kyphosis. During this procedure, the vertebrae causing the curvature are combined to create a single and fixed spinal segment. This corrects the curvature of the spine and provides a more stable structure.

Surgical Procedure Stages:

• The surgeon accesses the spine by making an incision in the middle of the back.
• Metal screws, rods, or other tools are used to ensure the correct alignment of the vertebrae.
• After the vertebrae are placed in the appropriate position, bone graft or similar materials are placed between the vertebrae and the fusion process is initiated.

Healing Process and Follow-up:

• After kyphosis surgery, the patient may stay in the hospital for 3-4 days or longer, depending on his condition.
• During the post-operative recovery period, a back brace can be used to allow the spine to heal properly.
• Patients can usually return to daily activities gradually within 4-6 weeks after surgery.
• Sports and heavier physical activities are usually started one year after surgery.

Risk and Things to Consider:

As with any surgical intervention, kyphosis surgery has risks such as infection, bleeding, nerve damage or, rarely, paralysis.
Therefore, when deciding on surgical intervention, the patient and the doctor must weigh the risks in detail and determine the most appropriate treatment plan.