What Is Kyphoscoliosis?

Most often referred to in the medical literature as kyphosis, kyphoscoliosis involves the abnormal front-to-back curving of the upper spine. Kyphoscoliosis most often develops in elderly women, but it can occur as early as birth. Patients with the condition generally respond well to treatments that range from physical therapy to surgery, but those treatments can be unwelcome. Still, left untreated, kyphoscoliosis leads to increasing disability, pain and possibly even death through pulmonary failure.

What It Is

• The upper vertebrae of the spine naturally curve out from the middle of the back and toward the neck. When this curve exceeds 40 degrees, a person begins stooping and can eventually develop a hunched back, experience pain and trouble breathing, and have weakness or paralysis in their legs.

Causes

• Kyphoscoliosis develops when the angle between vertebrae drops to less than 5 degrees. This compaction of vertebrae most often occurs in older people who have osteoarthritis, and more frequently in women than in men. The other leading cause of kyphoscoliosis is Scheuermann's disease, which for unknown reasons begins causing symptoms after a child reaches 10 years of age. Slouching, a neuromuscular disorder such as cerebral palsy or spina bifida, an injury or a tumor can also cause kyphoscoliosis. Rarely, babies are born with kyphoscoliosis.

Treatments

• The treatment for kyphoscoliosis depends on the cause of the condition. Newborns with kyphoscoliosis must have surgery soon after birth to stop the curving of the spine. Without the corrective surgery, which involves inserting straightening rods along the spine, kyphoscoliosis will worsen, and the child will become paralyzed or unable to breathe because his or her chest cavity gets too compacted.

  Failing to stand up straight can train the bones and muscles of the back to assume the slump-shouldered position. Improving posture through exercise and attention to how one is standing and sitting can prevent the development of kyphoscoliosis in otherwise healthy people.

  For a child who has Scheuermann's disease, therapeutic options include exercises, bracing and surgery. Surgery comes with risks such as infection and spinal damage, while wearing a brace can lead to low self-esteem. Information on kyphoscoliosis provided by the National Library of Medicine notes that "emotional support is important for adjustment to the limitations of treatment."

  Because kyphoscoliosis is secondary to the more-debilitating neuromuscular disorder in individuals with a condition such as spina bifida, surgery to straighten the spine in such people generally has the limited goal of reducing pain and allowing a person to sit up.

  Last, a combination of medications and surgery is indicated for adults who develop kyphoscoliosis as a result of a tumor or osteoarthritis.

Prognosis

• The spinal curving caused by Scheuermann's disease ceases when the child stops growing, and children treated for kyphoscoliosis due to any cause tend to maintain their degree of postural correction for their lives. Children who had kyphoscoliosis may develop chronic back pain in later life, however.

  Kyphoscoliosis caused by osteoarthritis continues to progress even with treatment.

Support

• Scoliosis Association, Inc. offers a range of patient information and support through its website. The nonprofit organization publishes a magazine titled Backtalk, sponsors local chapters, and offers fact sheets in English, French and Spanish. The Scoliosis Association also presents information on nonsurgical management of different types of spinal curvature.