Hyperkyphosis surgery

'You need surgery' isn't something you ever want to hear. But for some individuals diagnosed with hyperkyphosis, surgery may be the only viable option to improve their condition and reduce their back pain. Non-surgical treatment methods such as physical therapy are often explored before resorting to surgery; however, if the symptoms of kyphosis are still causing problems after a certain amount of time, doctors may recommend an operation.

Other criteria that are taken into consideration include:

  • Curve progression - If the curve of the spine is getting gradually worse, doctors may suggest surgery to correct the curve and halt the progression.
  • Curve severity - In the thoracic spine (upper back), curves that exceed 80 degrees are considered severe. In the thoracolumbar spine (mid-low back), curves greater than 60-70 degrees are classed as severe.
  • Neurological symptoms - Hyperkyphosis can affect the nerves in the spinal cord as a result of spinal changes (e.g. vertebral fractures, which may cause pinched nerves). This can result in numbness, weakness and tingling feelings. In severe cases, the patient may experience bladder or bowel dysfunction.
  • Balance - Due to the spine curving forward in kyphosis, patients may have difficulty standing up straight. If a case of kyphosis results in individuals leaning forward too far, making it difficult to complete everyday tasks, surgery may be needed to rebalance the spine.

The main aims of hyperkyphosis surgery are:

  1. Decrease pain and any neurological symptoms experienced
  2. Reduce deformity
  3. Stop the curve from getting any worse

A number of different surgical procedures may be used, including:

Osteotomy

Osteotomy is a surgical procedure that involves the cutting and reshaping of bones. For individuals who have been diagnosed with hyperkyphosis, osteotomy realigns the bone ends in their spine and allows them to heal. Spinal instrumentation and fusion may then be used to stabilise the spine during the healing process.

Spinal Fusion

Once the spine has been realigned through an osteotomy, surgeons are required to stabilise and help it to heal in its new position. To do this, the surgeon will create an area where the bones in the spine fuse together over a period of time (typically several months) using a bone graft. This fusion aims to prevent movement between the vertebrae, providing more long-term stability within the spine. Based on the severity and location of the kyphosis curve, the surgeon will dictate whether the spinal fusion is performed from the front (anterior approach) or the back (posterior approach).

Balloon kyphoplasty

Kyphoplasty is a minimally-invasive treatment that's performed through a number of very small incisions. Here, a special orthopaedic balloon is placed into the compressed vertebra and then inflated in an attempt to return the vertebra to the correct height and position. The balloon creates an empty space in the vertebra which is filled with a special surgical cement. This helps to stabilise the spine.

 

Hyperkyphosis surgery risks

As with any other surgical procedure, kyphosis surgery does carry some risks that you should be aware of before you decide to go under the knife. These include:

  • Infection
  • Blood clots
  • Instrumentation becoming loose or breaking
  • Development of a secondary curve

 

Treating hyperkyphosis without surgery

If you don't like the idea of having surgery, you'll be pleased to learn that it is often possible to treat Scheuermann's disease and other forms of hyperkyphosis without any invasive procedures. Here at Scoliosis SOS, we offer world-class therapy in the form of our ScolioGold programme, which helps to straighten the back, reduce feelings of pain and improve overall quality of life.

We can also help individuals who have already undergone hyperkyphosis surgery. Our combination of proven treatment methods can help to speed up the recovery process, easing the pain experienced post-surgery, improving mobility and correcting any secondary curves that may have developed above or below the fusion.

If you would like to find out more about why our treatment courses are a great alternative to surgery, please contact Scoliosis SOS and book an initial consultation with one of our scoliosis consultants, who will more than happy to recommend the best course of action for you.

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Hyperkyphosis

Hyperkyphosis (often just called kyphosis) is a curvature of the spine that occurs in the upper back, resulting in a hunched or stooped appearance.

It affects approximately 8% of the general population, and while it is most common in older people, it can affect men and women of all ages.

Watch our video to learn everything you need to know about hyperkyphosis:

Kyphosis is sometimes known as 'dowager's hump', particularly if the patient is getting on in years. 'Hunchback' is a somewhat derogatory term for a person with kyphosis.

 

Hyperkyphosis vs Scoliosis: What's the Difference?

Hyperkyphosis and scoliosis are two different curvatures of the spine.

We treat both conditions here at the Scoliosis SOS Clinic, and they can occur together (see kyphoscoliosis). But they're not the same thing.

Kyphosis vs scoliosis

The difference lies in the direction of the curvature:

  • Hyperkyphosis: Causes the upper* region of the spine to curve forwards, making the patient's upper back look unusually rounded or hunched.

  • Scoliosis: Causes the spine to curve sideways, forming a 'C' or 'S' shape.

*Excessive forward curvature of the lower spine is known as hyperlordosis. Read our Curvatures of the Spine guide for more information.

 

How Does Hyperkyphosis Affect the Body?

Kyphosis patients can usually be recognised by their visibly hunched backs, but this is just one of the many ways in which hyperkyphosis can affect one's body.

Kyphosis patients

Other symptoms of kyphosis include:

  • Back pain
  • Stiffness and discomfort
  • Reduced mobility / flexibility
  • Fatigue
  • Poor body image

But that's not all. A severe kyphotic spinal curve can even interfere with the body's most fundamental inner workings, such as the respiratory and digestive systems.

> How does hyperkyphosis affect breathing?

If hyperkyphosis is not treated and the spinal curve continues to get worse over time, there is a risk that it may eventually begin to adversely affect the patient's ability to breathe. This happens because especially severe spinal deformities inevitably end up warping other parts of the skeleton, including the rib cage; this leaves the lungs with less room to inflate, resulting in compromised breathing.

> How does hyperkyphosis affect the digestive system?

Severe hyperkyphosis can also impact on the patient's ability to digest food normally. Again, this is due to the knock-on effect that a pronounced spinal curve can have on other parts of the body. In the case of the digestive system, problems may arise because the patient's internal organs are being squashed together, potentially obstructing the passage of food through the intestines. Acid reflux is also fairly common among people with advanced hyperkyphosis.

> How does hyperkyphosis affect the nervous system?

In some cases, the distortion of the body due to hyperkyphosis can end up impinging on a nerve. Depending on where in the body this happens, nerve compression can lead to:

  • Persistent aches/pains
  • Numbness or tingling sensations
  • Certain body parts feeling weak
  • Loss of bladder/bowel control

The good news is that all of these consequences are relatively rare and do not arise in the majority of mild to moderate cases of hyperkyphosis.

 

What Causes Hyperkyphosis?

Kyphosis can develop for a number of different reasons, and some forms of this condition are more preventable than others.

Here are some of the most common causes of hyperkyphosis (and who they're most likely to affect):

  • Bad Posture - If you persistently slouch forward or lean back when seated, you may notice that your spine starts to develop a visible curvature over time. Desk workers are particularly prone to the sort of postural problems that can lead to hyperkyphosis.

  • Scheuermann's Disease - Scheuermann's disease typically occurs during the growth spurt that accompanies puberty. If you have this condition, it means that your vertebrae (the bones that make up your spine) develop into a wedge shape, creating a forward spinal curve. Learn more about Scheuermann's disease here.

  • Congenital Issues - While rare, it is sometimes the case that a baby's spine will develop incorrectly in the womb, and this can mean that hyperkyphosis is present from birth. This is called congenital kyphosis, and when it does occur, it usually begins within the first 6-8 weeks of embyronic development.

  • Osteoporosis - Human beings (especially women) often lose bone density as they get older, a condition known as osteoporosis. The resulting bone weakness can lead to a range of different problems, including curvature of the spine. Learn more about osteoporosis here.

  • Spinal Injury - Certain accidents and injuries can impact the spine, resulting in hyperkyphosis in some cases.

 

How to Prevent Hyperkyphosis

While hyperkyphosis can be treated, it is often impossible to prevent it from developing altogether.

Scheuermann's kyphosis and congenital kyphosis cannot be prevented with lifestyle changes. Good posture will reduce your risk of developing postural kyphosis, and a healthy diet and weight-bearing exercises can help to prevent kyphosis from developing as a result of osteoporosis.

If you want to prevent hyperkyphosis, here's what we recommend:

  • Avoid rounding your shoulders and make an effort to observe your posture when sitting, walking or standing.

  • Perform exercises which increase bone mass - rebounding on a trampoline is very effective for this, and is even used by astronauts preparing for space travel.

  • Eat a diet rich in Calcium and Vitamin D, such as spinach, fatty fish and fortified foods.

  • Perform exercises to improve your posture at home, especially if you work in a job that requires you to sit for long periods of time or lift heavy objects. Here are some exercises to get you started.

  • Seek physical therapy from a qualified professional who will be able to identify the cause of your poor posture.

 

Hyperkyphosis Treatment

As with scoliosis, there are a number of different hyperkyphosis treatment methods in use, including both surgical and non-surgical options.

Congenital Kyphosis Treatment

The most prevalent treatment methods are:

  • Bracing - During adolescence, bracing may be required to stunt the progression of the patient's kyphosis in moderate to severe cases. Bracing aims to ensure that the degree of the curvature does not develop any further than it already has. The patient may be required to continue wearing the brace until their spine stops growing at around 16 years of age. Learn more about how a hyperkyphosis brace works here.

  • Pain Management - As is the case for many health problems, pain management is often a central part of hyperkyphosis treatment. Painkillers such as ibuprofen or paracetamol can help to relieve the aches and pains that derive from having a curvature of the spine. If the patient is in a lot of pain, stronger pain relief medications may be prescribed.

  • Physical Therapy - Though it does require some work on the patient’s part, physiotherapy is a great way to treat hyperkyphosis. Physical therapy programmes such as our own ScolioGold method can straighten the back, reduce pain, and improve the patient's quality of life in general - see before and after photos here.

  • Surgery - If the curvature becomes so severe that the patient is having difficulty going about their day, surgery may be recommended. Spinal fusion is the standard surgical procedure for hyperkyphosis - this involves fusing the vertebrae together to correct the spine's curvature. Method rods, screws, hooks and bone grafts are used during the operation to fuse the bones together. The operation takes 4-8 hours, and a back brace may need to be worn for up to 9 months while your spine heals.

 

Matthew from Exeter: A Kyphosis Case Study

Matthew Ellison came to the Scoliosis SOS Clinic in 2018. Our treatment course helped to reduce his back pain, and he actually grew by 3.8cm during his time here!

Read Matthew's story in full here. Matthew is just one of the many hyperkyphosis patients we've helped - if you'd like to find out more about our physical therapy courses, please give us a call on 0207 488 4428.

Learn Some Hyperkyphosis Exercises   Book Your Initial Consultation

Previously on the Scoliosis SOS blog, we have talked about some of the exercises that scoliosis sufferers can perform at home in order to combat their condition. But while these exercises work well on a sideways spinal curve, they may not be so effective if you suffer from hyperkyphosis - a forward curve of the upper (thoracic) spine.

We at the Scoliosis SOS Clinic treat each patient using a combination of non-surgical spinal techniques to ensure that all aspects of their condition are fully treated, without the use of a brace or spinal fusion surgery. To help you overcome your hyperkyphosis, we're going to run through a few exercises you can do at home that will help relieve some of your symptoms.

Please note that these stretches should not be used as a substitute for a full treatment course delivered by a chartered physiotherapist.

Superman Stretch

Superman Stretch

  1. Lie on your stomach and extend your hands in front of your head.
  2. Keeping your head in a neutral position, look towards the floor, and lift your legs and arms up towards the ceiling.
  3. Reach away from your body with your hands and feet.
  4. Hold this position for 3 seconds, and repeat 10 times.

 

Happy Cat Sad Cat Stretch

Happy Cat, Sad Cat Stretch

The goal of this stretch is to increase the mobility of your spine.

  1. On all fours, place your knees hip-width apart, with your hands under your shoulders. Keep your spine in a neutral position.
  2. Round your back, tuck your bottom under, and drop your head between your arms.
  3. Holding this position, inhale and try to curve your back even further to increase the stretch.
  4. Then, during exhalation, arch your back, stick your bottom out, and look up towards the ceiling.
  5. Repeat this cycle 10 times, using your breathing to help you slowly transition between the two positions.

 

Head Retraction Stretch

Head Retraction Stretch 

The goal of this exercise is to stretch and exercise weakened neck muscles.

  1. Lie down on the floor, and pull your chin in as if you were trying to make a double chin.
  2. Hold this for 15 seconds, and repeat five to ten times.

 

Chin Retraction Stretch

Chin Retraction Stretch

This exercise stretches your deep neck extensors.

  1. Stand up as straight as you can - you can do this against a wall if it helps. 
  2. Tuck your chin slightly, and bring your head back directly over your shoulders. 
  3. Bring own, and hold this position for 30 seconds - take a break if you begin to feel pain.

If you suffer from hyperkyphosis, please do not be afraid to contact us - we'd be overjoyed to help you overcome your condition with our non-surgical treatment regime.

Disclaimer: The above information should not be treated as medical advice and the scoliosis exercises described may not be suitable or beneficial for everyone. You should not begin any exercise routine without consulting a qualified health practitioner, particularly if you are pregnant, nursing, elderly, or if you have any chronic or recurring conditions. Any application of scoliosis exercises suggested is at the reader's sole discretion and risk. Scoliosis SOS accepts no responsibility or liability for any loss or injuries caused directly or indirectly through the performing of any exercises described. If you feel any discomfort or pain during exercise, stop immediately. Always consult your own GP if you are in any way concerned about your health or anything associated with it.

Susanne Henderson (a 69-year-old woman from Totnes, Devon) contacted the Scoliosis SOS Clinic in the hope that we'd be able to treat her hyperkyphosis. Read on to hear her story and how we were able to help her and reduce her spinal curve!

Hyperkyphosis case study

Susanne, unlike the majority of patients we treat here at the Scoliosis SOS Clinic, doesn't have scoliosis. Rather, she has a condition known as hyperkyphosis, characterised by an excessive forward curvature of the thoracic (upper) spine.

Susanne was diagnosed with hyperkyphosis following a series of accidents that gave her back a rounded shape and left her experiencing mild to moderate pain in her spine. When the medical professionals Susanne consulted didn't take her worries seriously enough, she decided to take it upon herself to find the treatment she needed.

Susanne contacted the Scoliosis SOS Clinic to enquire about our ScolioGold treatment programme. Although the corrective course is quite intensive, Susanne says that she has "coped very well", and that she appreciated being allowed to perform exercises at her own pace while still being pushed. When asked what she would say to other individuals with hyperkyphosis, Susanne recommended: "start taking action yourself and treat it before it gets worse".

As a result of the corrective exercises we have prescribed for Susanne, she says she's started to feel more "liberated, empowered and confident", and she is confident that she can carry on improving now that her ScolioGold course has come to an end.

To see a full account of Susanne's story, watch the video below:

If you have any questions about the Scoliosis SOS Clinic, or if you would like to book an initial consultation with us, please get in touch today!

Contact Us >

In November 2018, the Scoliosis SOS Clinic helped treat Matthew Ellison, a 31-year-old male from Devon who was diagnosed with hyperkyphosis and hyperlordosis following an injury. Here is his story!

Kyphosis and Lordosis Treatment

As Matthew explained to us, he had always noticed that his back had a rounded shape, particularly in the shoulder and thoracic region. During Matthew's early teenage years, his mother took him to the doctor to have his back looked at, and the doctor informed him that he would simply grow out of it.

As the years went by, however, Matthew saw that he hadn't grown out of it, and in his mid-to-late 20s he started to experience increased levels of discomfort and pain on a daily basis - and especially during sports participation. Things got worse for Matthew when he suffered an injury, which resulted in an X-ray scan and a recommendation for spinal fusion surgery. This was something that Matthew was not keen on at all and wanted to avoid, and so his doctor suggested that he could try a non-surgical treatment programme like the Schroth method. Matthew conducted some of his own research, and this eventually led him to the Scoliosis SOS Clinic.

Before reaching out to us, however, Matthew attempted to self-medicate his back problem with regular physical exercise in an effort to 'open up' the curve in his spine and strengthen his upper back muscles. Unfortunately, due to the injury that he had suffered, these exercises ended up making his spine worse. Matthew then sought professional help and undertook a 12-week physiotherapy course in the hope of correcting his spinal curvature; during this time, he was given simple instructions which helped with pain relief at the end of each day, but weren't enough to reduce the curve.

Matthew comes to the Scoliosis SOS Clinic

Matthew found the Scoliosis SOS Clinic's website via Google and decided to get in touch. After a simple phone call that answered a lot of Matthew's questions, he decided to undertake a 4-week ScolioGold course with us to help alleviate the problems that he was experiencing. Matthew was sceptical at first regarding the efficacy of group-based therapy, but was very impressed with the level of attention he received during his one-on-one sessions. The treatment that we provided comprised massage for pain relief and specific exercises that targeted the affected area of Matthew's spine.

Upon the conclusion of his treatment course, Matthew's hyperkyphosis and hyperlordosis had returned to within normal range. Not only was he no longer in pain, he had actually grown 3.8cm taller!

Matthew recommends the Scoliosis SOS Clinic to anyone experiencing back problems like his. Watch the video below for a full account of Matthew's story and to see how the Scoliosis SOS team were able to help him.

If you have any questions about the Scoliosis SOS Clinic, or if you would like to book an initial consultation with us, please get in touch today!

Contact Us >

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