Kyphosis and review of the literature

Abstract

AIM:The term kyphosis is used to describe the spinal curve that results in an abnormally rounded back. Kyphosis may develop due to trauma, developmental anomalies, degenerative disc disease, inflammatory diseases, and infectious diseases and also iatrogenic. The aim of this paper is to review the etiopathognesis and the treatment management of kyphosis. METHODS:A search in the National Library of Medicine (Pubmed) database using key word 'kyphosis' and was made. For the literature review, papers concerning etiopathogenesis, classification and treatment were selected among these papers. RESULTS:A search in the National Library of Medicine (Pubmed) database using key word 'kyphosis' yielded 7506 papers published between 1916 and 2013. The main papers about kyphosis were congenital, Scheuermann, tumour related, neuromuscular, posttraumatic, infectionrelated, iatrogenic kyphosis. CONCLUSIONS:Every patient with kyphosis should be treated based on her/his current state and needs. It should always be remembered that the patients with negative sagittal balance can compensate it with the hip flexion but it is far more difficult to compensate the positive sagittal balance. The main goal of surgery to treat the kyphotic patients is to correct the sagittal curve and also restore a spinal balance within an acceptable range above the hips and knees.

Radiological imaging findings of scheuermann disease

“…SD has been defined by Holger Werfel Scheuermann, a radiologist, in 1920 and has also been known as osteochondritis juvenile dorsi or kyphosis dorsalis juvenilis[4,9]. In SD, which leads to rigid kyphosis of vertebra, lower thoracic and upper lumbar regions are affected.…”

“…In SD, which leads to rigid kyphosis of vertebra, lower thoracic and upper lumbar regions are affected. It could involve a few vertebra segments or the whole vertebra[4]. Two patterns have been defined in SD based on affected area of vertebra[10].…”

“…In more typical pattern, thoracic region is frequently affected and is characterized by thoracic kyphosis increase and wedging in vertebra corpus. This pattern is accompanied by nonstructural hyperlordosis of cervical and lumbar spine[4,6,10]. SD of atypical pattern (thoracolumbar or lumbar) has been defined later and is distinguished from typical one by lack of thoracic kyphosis and evident wedging in corpus of vertebrae[11] which is considered to be more progressive in adulthood[6,10,12,13].…”

“…Disorganized endochondral ossification, collagen decrease and mucopolisaccaride increase in vertebral endplates have been reported in histopathology of SD[6]. As secondary to these, intervertebral discs can be influenced due to low quality endplate development, which could in turn pave the way for the degenerative disease[4,8]. SD frequently has a benign prognosis and can lead to small deformities and symptoms.…”

“…Muscular tension after long-term sitting or movement often induces lumbar pain. Lumbar pain may also be result of spine damage due to disc herniation or spondylolysis[4,8,20]. Deformities are usually noticed during school age.…”