Thoracic Kyphosis



If you look at yourself in the mirror, you will notice that the spine is not a straight line when viewed from the side. It has a natural S-shaped curvature that gives it flexibility and support. The curved parts of the spine also allow it to act as a spring that absorbs shock.

The outward curve in the thoracic spine (where the ribs are attached) is called kyphosis, and it normally ranges from 20-45 degrees.

In essence, kyphosis is normal. The exaggerated outward curvature is medically known as hyperkyphosis, and it measures more than 50 degrees. However, since kyphosis is the term commonly used to refer to hyperkyphosis, we will be using this term in this article.

What are the signs and symptoms of thoracic kyphosis?

Because of the outward curvature of the upper back, patients with this condition look round-backed or hunchbacked. Although it can affect people of any age, it commonly develops during adolescence because of rapid bone growth. 

Thoracic kyphosis can range from mild to severe. Patients with greater curvature experience worse symptoms than those with mild cases, who may experience no symptoms at all.

The signs and symptoms of thoracic kyphosis include:

  • Forward and stooped posture
  • Spine stiffness
  • Loss of height
  • Fatigue
  • Difficulty maintaining an erect or upright position
  • Back pain, which can range from mild to severe

As the curvature gets worse, patients may also experience:

  • breathing difficulties because of inadequate lung expansion
  • loss of sensation caused by spinal nerve compression
  • weakness and numbness in the lower extremities
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What are the causes of thoracic kyphosis?

Several factors may cause thoracic kyphosis. These include:

  • degenerative changes, such as in people with osteoporosis and spinal arthritis
  • neuromuscular disorders like cerebral palsy and muscular dystrophy
  • nutritional deficiencies, such as vitamin D deficiency

Kyphosis can also develop due to poor posture. Spending a lengthy amount of time in a bent position can weaken the spinal muscles and ligaments. Postural kyphosis is the most common form of thoracic kyphosis.

How is thoracic kyphosis diagnosed?

If the curvature is mild, the kyphosis may go unnoticed. Oftentimes, the concern for appearance is what prompts patients to see a doctor.

When you visit our orthopedic spine surgeon in Palm Beach County, he will take your medical history and perform a physical assessment of your condition.

During the physical examination of your back, our doctor will have to ask you to bend forward at the waist while standing with both feet together and arms hanging free. When you are in this position, your doctor can better see any curvature or deformity. The doctor will also press or tap on some areas and observe your response or ask questions.

After history taking and physical examination, you may have to get some laboratory and imaging tests done. These may include:

  • X-rays from different angles to see any deformities in the spine and to measure the kyphotic curve.
  • Pulmonary function tests for patients with severe kyphosis to determine if their breathing is already affected by the limited space.
  • MRI (magnetic resonance imaging) for patients who already experience neurologic symptoms like tingling, numbness, and weakness in the lower part of the body.

What are the treatment options for thoracic kyphosis?

The treatment varies per patient and will depend on several factors:

  • Age and health status
  • Type of kyphosis
  • Remaining growth years
  • The severity of the curve
  • Affected organs

A majority of patients with thoracic kyphosis do not need treatment. Those with mild cases are only required to perform prescribed exercises, take pain medications as needed, and wear braces to stop the curve from progressing.

Do I need surgery for thoracic kyphosis?

Spinal fusion, the surgical procedure to treat thoracic kyphosis, entails the fusing together of affected vertebrae in the upper back so that they would heal and form a single bone. Once healed and recovered, patients can enjoy decreased thoracic curvature and minimal back pain.

This surgical procedure is recommended for:

  • Patients who have had a thoracic kyphosis since birth (congenital kyphosis).
  • Patients whose back pain can no longer be relieved by conservative treatment.
  • Patients whose Scheuermann’s kyphosis is greater than 75 degrees.

To learn more, read our post about other surgical procedures for treating thoracic kyphosis.

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When to seek medical help

We recommend that you consult our spine expert as soon as you observe any deformity in your spine.

According to our spine surgeon in Fort Lauderdale, early diagnosis and treatment of thoracic kyphosis is the key to successful treatment and leading a healthy life. Our doctor also warns that, if left untreated, it can lead to complications in appearance, breathing, movement, and even digestion.

Consult our orthopedic spine surgeon in Delray Beach

If you are experiencing difficulty standing upright or having balance problems caused by thoracic kyphosis, Dr. Matthew Hepler is ready to help. He has years of experience in adult and pediatric spine surgery, so you are in good hands.

We have accessible clinic locations in Fort Lauderdale (Broward County), and Delray Beach (Palm Beach County) for your convenience. For more information, Contact Us.

The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.