The word kyphosis denotes the condition of the vertebral column in which a ‘C’ shaped curve appears in the vertebral column. The opening of the ‘C’ is at the anterior side of the body. It means that the concavity of the curve is in front of the torso. The normal anatomy of the vertebral column is of such type that has 3 curvatures but in a small amount. When these anatomical curvatures become larger, they create a problem. The normal curvature of the cervical and lumbar region of the vertebral column is reverse C shaped which is also known as lordotic curves. If the cervical region of spinal column loses its normal curvature which is lordotic (reverse C shaped) and begins to curve in the forward direction instead, it is an abnormal condition which is termed as cervical kyphosis. This abnormal forward curvature not only distorts the shape of the vertebral column and has a cosmetically bad impact but also produces some other complications. The signs and symptoms of kyphosis may be variable. The degree of severity of the disease range from small change to the normal anatomical shape of the back and neck to severe form of deformity, chronic pain, and neurological deficit.
Different Forms of Kyphosis
Following we’ll describe the various types of cervical kyphosis:
- Postural Kyphosis. It is the most cause of kyphosis which is also attributed to slouching. It can be corrected by treating the imbalance in the muscles and ligaments of the back by using braces or by performing regular exercises.
- Juvenile Kyphosis. It is more rigid and severe sort of deformity which creatures much cosmetic impairment. It can run in families, hence has genetics in origin. Classically it appears in younger adolescent boys. It can be corrected by surgical intervention or braces.
- Congenital Kyphosis. It appears at birth. It takes place if the vertebral column of the child is not normally developed in the uterus of the mother. Most commonly, it needs surgical intervention for treatment.
Causes of Cervical Kyphosis
There are several causes of cervical kyphosis some of which are described as following:
- Degenerative Disc Disease. The process of degeneration of intervertebral disc creates many problems in the vertebral column. Disc degeneration process is also age-related. Age-related wear and tear changes cause the disc to collapse. The weight of head imparts an extra pressure to the discs of the cervical region of the spinal column. This imbalance of forces pushes the neck in the forward direction. This process slowly leads an enhancing curvature and result in cervical kyphosis.
- A birth defect is the second most common cause of cervical kyphosis. If a baby is born with a malformation of the vertebral column, it leads to a kyphosis type curvature in the cervical area. Congenital anomalies also cause the growth disturbances of the vertebral bones. Vertebrae do not grow in their normal shape, instead, they grow in a triangular shape in such a way that the pointed end is directed forward. As you know that the vertebrae are arranged in such a way that they are stacked upon each other, this triangular shape creates an abnormal forward curve in the vertebral column. When there is a congenital kyphosis in a child, most probably other birth defects might also be present like defects of heart, urinary system and kidneys. Treatment option of the congenital form of kyphosis is only surgical intervention.
- It is the third leading cause of cervical kyphosis. It takes place due to an injury or trauma to the cervical region of the spinal column. Injury may be to the ligaments of the cervical region or it may also occur due to a compression fracture of the vertebral bones. It is to be noted that when a vertebra has an injury in the form of a compression fracture, the body of vertebrae usually heals in a wedge shape. This results in a similar situation which is discussed above and thus, forward positioning of the cervical spine takes place gradually ending up in kyphosis.
- Iatrogenic cervical kyphosis may also happen after a failed attempt at vertebral column fusion.
Other less common causes of cervical kyphosis are an infection of the vertebral column, tumors of the vertebral column or some systemic diseases which have an impact on spine also like ankylosing spondylitis.
Symptoms of Cervical Kyphosis
Symptoms of cervical kyphosis range from mild deformity to severe deformity even paralysis of untreated. Some of the symptoms are following:
- Mechanical neck pain if you are suffering from kyphosis due to degenerative disc disease.
- Decreased range of movements in the neck. It means that the affected person is unable to fully rotate his neck.
- Problems with the nerve roots of the vertebral column if the kyphosis is severe due to pressure effect. It results in a decrease in the strength of grip, weakness or pain in the arms or legs and difficulty in walking due to muscle spasm in legs.
- Loss of bowel or bladder function if the nerve supplying the bladder and anal sphincters impinge.
- Paralysis occurs in very severe circumstances.
How it is Diagnosed?
Kyphosis is diagnosed by taking a good history and performing a thorough physical examination. History is necessary to know the underlying cause of kyphosis. Following questions are essential to ask in history.
- When did the pain start?
- Do you feel weakness, numbness or tingling sensations in the upper and lower extremities ?
- Have you had any trauma or injury?
- Have you had any surgery of back?
- Does the pain radiate to your arms and legs?
- Do you face any problem while walking?
- Do you have any problem in the bowel or bladder function?
Before making a final diagnosis, the doctor performs a complete physical examination specifically the examination of the neck. The doctor will see the following things in the examination.
- Up to what extent, you are able to bend your neck and move your head in all directions.
- How well you are able to roll your neck.
- If there is pain or tenderness in the cervical area
- Is there any spasm in the cervical region or in other regions of the back.
Tests to know the functions of nerves are also important. These tests include
- Testing for numbness and tingling sensations in the hands, wrist, and arms.
- Tests for reflexes.
- Testing the strength of musculature of legs, hands, and arms.
- Testing for the functions of nerves.
Your doctor may also order the relevant investigation to know the condition of the back. These radiological investigations include
- CT scan
The Most Effective Treatment of Cervical Kyphosis
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