A&P Section 023
The Killer Impact of Kyphosis
Kyphosis has been around for many years, some documented and other unnoticed and untreated. Kyphosis is often times referred to as hunch back or an abnormally curved spine. Although every one’s spinal cord does have some round like shape to it or series of curves, someone with Kyphosis with have an abundant amount of rounding to their spinal cord. This abnormal curve will generally occur on the thoracic part of the spine, when looked at from the side of a person. The natural curvature of someone’s spine will curve at the cervical, lumbar and thoracic part of the spine. A patient with Kyphosis will still have all these natural curves to their spine that help stabilize, manage weight from the head and absorb shock. However, if you have this deformity the lumbar portion of your spinal cord will be pushed further out causing your natural curve to be a lot larger than the normal curvature (Oda et al.1999). Kyphosis can be postural, congenital or be caused by degenerative disease or extreme trauma. Furthermore, neurofibromatosis, Paget’s disease, spondylolisthesis, osteoporosis and tumors have been shown to cause some cases of Kyphosis
This disease can be easily diagnosed from the most part. This usually can be self-diagnosed if you know what to look for. If you think you may suffer from hunch back, you may be able to look in the mirror and notice that your spinal cure is not as normal as other’s. Other cases that are not as noticeable can be diagnosed based on a physical examination from your doctor or an X-ray exam. X-rays will be viewed for an abnormal spinal curve. Scheuermann’s kyphosis disease is diagnosed with thoracic kyphosis measuring more than 40° with wedging of three or more vertebrae in a row (Polly et al. 2017). Although symptoms can range from simple nuisance to extremely server pain and discomfort, everyone with Kyphosis will have some type of symptoms. Some noticeable by looking at the spine others will need to be tested for.
One of the more popular symptom that has been reported is difference in shoulder height and position.
This is the most common symptom but symptoms will vary depending on the person ad severity. Some other symptoms are reduced range of motion in the neck and back area. This can make it hard for people with this disorder to rotate their neck fully or sit in an upwards position for an extended amount of time. In serve cases it will cause a change in bowel movement or loss of control over the bladder. This is due to increase pressure on the spinal nerve root and spinal cord. In most cases the patient will also experience loss of grip, weakness in shoulder and legs sometimes leading to paralysis from the neck down (Sinai Cedars 2018).
Since Kyphosis has been linked to many different bone and structure disorders there has been great effort put into treatment for this disorder. The treatment options will differ for each individual case. Your options for treatment will depend on the severity, symptoms that are present, cause and age of the patient. The three main options are medication, therapy and surgery. For younger children or a person who is still growing usually the best treatment would be surgery. Having surgery done in the early stages of Kyphosis will be able to stop the progression of having the hunch back. Often time’s parents don’t want their child going under intense surgery like this one (Kids Health 2014). In these cases, doctors will recommend the bracing method. The brace will correct the formation and alignment of the bones while the child is still growing. If Kyphosis is causing serve pain due to pinching of the nerve root or spinal cord surgery will be highly recommended for adults as well. This surgery will reduce the curvature in the spine.
The procedure that will be performed is called a spin al fusion. The doctor will place a piece of bone two or more of the affected vertebrates, then tighten them together aligning the m with one another with metal rods (Cheng et al. 2013). This will remain in the patients back until the spine heals together in the correct position. Lastly, medication will be another form of treatment for some patients. Medication will usually be recommended for the older population that is affected. These will be bone strengthening drugs that will promote bone strength and keep condition from worsening. This is usually given to elderly people because the surgery will have more negative effects on them then positive. Also medication will be the best treatment for them since their bone have already grown as much as they are going to grow. The medication that will be prescribed will be limited to nonsteroidal anti- inflammatory drugs, these will decrease inflammation, relieves pain and reduces fever (NCBI 2010).
Tramadol is often referred to as Ultram can be prescribed to a patient with excruciating pain or to patients who have very little hope for recovery. Like morphine, tramadol binds to receptors in the brain. That are important for transmitting the sensation of pain from the body to the brain (Mahowald et al. 2005). This opioid can help but is also very powerful. This is usually taken in pill form but for those with hunch back it can also be injected. Tramadol is assessable, patients say this is one of the most effective drugs for pain. Some believe that Tramadol is a better alternative because it does not increase risk of internal bleeding and stomach ulcers. However, it has been reported as one of the most dangerous when used for an extended amount of time continuously. It can be extremely addictive both physiologically and physically. In general tramadol has some unpleasant side effects such as drowsiness, constipation and nausea but if you become dependent on it as many people do. It can cause more side effects when trying to reduce the use of this medication. If a user tries to reduce the use of this opioid they may experience restlessness, anxiety joint pain and weakness as well as increasing heart rate. These are all signs that you have become dependent or addicted to this drug.
New research has been done on this disorder within the past four years insinuating that this possibly can be a factor of decreased pulmonary function in elderly people who suffer from kyphosis. Chronic obstructive pulmonary disease takes away from the diaphragmatic mobility, causing deformities in the thoracic cavity and increasing the angle of the thoracic curvature. This is causing difficulty breathing and serious health issues for this population. This disorder is currently affecting up to percent of the elder population (New Medical 2016). This doesn’t account for the elderly who acquire injuries on the day to day bases that effect their shape or curve of their spinal cord.
This is becoming a big deal because some researchers believe that if an older patient hadn’t had this hunch back or spinal curve, this could have increased their life span. Amanda Lorbers believe that some elderly deaths could have been related to pulmonary restriction due to Kyphosis but have gone undocumented. This disease is very common and closely linked with other bone disorders. It may not be preventable in most cases or curable but it is definitely treatable. This disorder is a disorder that people need to be aware of because this can contribute to the cause of your death or even one of your loved ones. Awareness and prevention is the best treatment.
Cheng, Li Ming, et al. “Pedicle Screw Fixation for Traumatic Fractures of the Thoracic and Lumbar Spine.” Cochrane Collection EBSCO, 31 May 2013, cochranelibrary-wiley.com/doi/10.1002/14651858.CD009073.pub2/full.
Oda, Itaru MD, et al. “Does Spinal Kyphotic Deformity Influence the Biomechanical. Spine.” LWW, 1999, journals.lww/spinejournal/1999/10150/Does_Spinal_Kyphotic_Deformity_Influence_the.14.asp
Polly, David, et al. “What Are the Indications for Spinal Fusion Surgery in Scheuermann Kyphosis.” PubMed, 30 Jan. 2017, www.ncbi.nlm.nih.gov/pubmed/28141687.
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Matthew Hughes, Jason Bernard, Matthew Szarko. “Scoliosis Research Society.” SRS: Scoliosis Research Society, 2018, www.srs.org/patients-and-families/conditions-and-treatments/adults/kyphosis.
Samelson, Lisa and Amanda Lorbergs. “Reasearchers Quantify Impact of Hyper kyphosis on Decline in Pulmonary Function.” News-Medical.net, 29 July 2016, www.news-medical.net/news/20160729/Researchers-quantify-impact-of-hyperkyphosis-on-decline-in-pulmonary-function.aspx.
Sinai, Cedars. “Kyphosis.” Cedars-Sinai,2018,www.cedars-sinai.org/health-library/diseases-and-conditions/k/kyhosis.html.
Katzman, Wendy B. et al. “age related Hyper Kyphosis.” The Journal of Orthopedic and sports physical Thearphy, U.S. National Library of Medicine, 6 June 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC2907357