Kyphosis: Questions/Answers - Part 2
Kyphosis: What is it?
How do people find out if they have kyphosis?
A doctor can tell if a person has kyphosis. Orthopaedic surgeons (or-tho-pee-dick sir-juns), Neurosurgeons (nur-row-sir-juns), and Chiropractors (k-eye-row-prac-tors) know about spine problems. There are three parts to the doctor's examination:
(1) Physical Examination
During the physical examination, the doctor looks at the back and feels the spine. The patient bends forward, bends backward, to the side, and twists to show the doctor how the spine moves. This is called Range of Motion. Some people with kyphosis find it hard to do certain movements. Kyphosis is best seen from the side, both standing straight and bending forward.
(2) Nervous System Examination
Next the doctor evaluates the nervous system. The nervous system includes the brain, spinal cord, and nerves that extend like tree branches through the body. The nerves carry messages to and from the brain to control the body. This includes motor functions (like movement) and sensory functions (like feelings). The doctor will ask if any part of the body is painful, tingles, is numb, or feels weak. Because the nerves make everything work in the body, the doctor also asks if the patient is able to go to the bathroom normally.
(3) Imaging Tests
X-rays, also called Radiographs, are taken of the spine with the patient standing and laying down. The side and back of the spine are x-rayed. The Radiologist (ray-dee-all-o-gist) can see problems in the spine including big curves and pie shaped vertebrae. The Radiologist examines the x-rays and sends a report to the doctor. X-rays are also used to measure the size of the curve in the spine.
If the doctor thinks there is a nerve problem, another test called an MRI is performed. MRI stands for Magnetic Resonance Imaging. The pictures this machine makes are very detailed. The doctor can see all the structures in the spine.
How is kyphosis treated?
Early treatment is important to stop the curve. If kyphosis is caused by poor posture, there are exercises the patient can do to make the muscles in the spine stronger. Patients learn these exercises and how to correct their posture during Physical Therapy.
Kyphosis caused by a structural disorder is treated in a different way. The doctor may give the patient medications to control pain. Sometimes a special brace is worn to help control pain.
A brace is also worn to help stop the curve from getting bigger. There are different types of braces. At first, the brace may need to be worn 24-hours a day. The doctor tells the patient how to wear the brace. Everyone is different. Wearing a brace can be hard because it may feel uncomfortable at first. It may take the patient some time to adjust to how the brace looks and feels.
Is an operation needed?
Kyphosis can cause a severe deformity if it is not recognized early. Sometimes surgery is needed to reduce the kyphosis, fix the spine, or stop pain.
Surgeons use special hardware to correct the spine. Things like rods, bars, wire, plates, and screws are made from steel or Titanium, metals that are body-friendly. During surgery, these metal pieces are joined with the spine inside the body making it stable and strong. After surgery, the hardware cannot be seen because it is inside the patient's body. This is called Spinal Instrumentation.
Sometimes a small piece of the spine is removed to help correct the curve. The surgeon might fill the empty space with pieces of bone. This is called Bone Graft. Bone used for bone grafting can be taken from the patient's own body or a donor. Bone graft will grow and attach to other bones in the spine. This is called Fusion. But it takes time for bone graft to grow, so Spinal Instrumentation is used to hold the spine straight and stable as Fusion occurs.
Patients who are treated with a brace or have surgery continue to see the doctor who will check the patient's progress and make sure everything is okay. The patient is often able to return to normal activities after surgery if the surgeon feels the patient is making progress.
Physical Therapy may be added to the patient's treatment plan. The therapist creates an exercise program to suit the patient's needs. The goals include building strength, flexibility, and increasing range of motion.