What do doctors call this condition?

Kyphosis

What is this condition?

Humpback is a frontward curving of the spine that causes a bowing of the back. A normal spine is slightly curved, but a severe curve, usually at chest level, is harmful. In adults and children, humpback is successfUlly treated with braces and exercises. It rarely requires surgery.

What causes it?

Adults and children get humpback for different reasons.

Adolescent humpback

The most common form of adolescent humpback is linked to growth retardation, a blood circulation problem around the spine during periods of rapid growth, or even poor posture. Sometimes, infection, inflammation, and disk degeneration can put vertebrae under stress and produce the curve. Humpback is discovered in more girls than boys and most often between ages 12 and 16.

Adult humpback

Adult humpback may result from aging and related degeneration of disks between the vertebrae or from the collapse of vertebrae. The list of contributing diseases and conditions is long: hyperparathyroidism, Cushing's disease, prolonged corticosteroid therapy, arthritis, Paget's disease, polio, fractured vertebrae, cancers, or tuberculosis. In adults, as well as children, humpback can result from poor posture.

Congenital humpback

This disorder, in which the vertebrae are badly formed, is rare but usually severe enough to press against the lungs.

What are its symptoms?

Development of adolescent humpback is usually subtle, but the clues include:

• curving of the back, often after a history of excessive sports activity

• mild pain at the top of the curve (in about half of affected adolescents)

• fatigue, tenderness, or stiffness in the involved area or along the entire spine

• prominent growths on vertebrae, producing swayback and hamstring tightness

• neurologic damage and spasms (rarely)

• inability to straighten the spines while lying down (reported in adolescents and adults).

Adult humpback produces the characteristic roundback appearance and the following symptoms:

• pain (possibly), weakness of the back, and generalized fatigue

• tenderness (rarely), except when the humpback is linked to osteoporosis or a recent fracture (as in elderly people).

How is it diagnosed?

The doctor can see the curvature, and X-rays may show changes in the shape of vertebrae. To confirm adolescent humpback, the doctor will check for tuberculosis and other inflammatory or new-growth­producing diseases. Because these suspected diseases cause severe pain and other definite symptoms or test results, they can be ruled our quickly.

How is it treated?

For humpback caused by poor posture alone, the usual treatment includes:

• bed rest on a firm mattress (with or without traction)

• a brace to straighten the curve until spinal growth is complete

• therapeutic exercises

If treatment is needed for other diseases that cause humpback, the doctor may fuse the bones in the spine to relieve symptoms. Although rarely necessary, the surgery may be recommended when humpback causes nerve damage, a spinal curve greater than 60 degrees, or stubborn and disabling back pain in an adult.

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