Roundback

Alternative names

Scheuermann's disease; Kyphosis; Hunchback; Postural kyphosis

Definition

Kyphosis is a curving of the spine that causes a bowing of the back, which leads to a hunchback or slouching posture.

Causes, incidence, and risk factors

Kyphosis is a spinal deformity that can result from trauma, developmental problems, or degenerative disease. Kyphosis can occur at any age, although it is rare at birth.

Adolescent kyphosis, also known as Scheuermann's disease, results from the wedging together of several consecutive vertebrae (bones of the spine). The cause of Scheuermann's disease is unknown.

In adults, kyphosis can be a result of osteoporotic compression fractures (fractures caused by osteoporosis), degenerative disease (such as arthritis), or spondylolisthesis (slipping of one vertebra forward on another).

Other causes of kyphosis include the following:

• Infection (such as tuberculosis)
  
• Neurofibromatosis
  
• Connective tissue disorders
  
• Muscular dystrophy
  
• Spina bifida (a birth defect involving incomplete formation of part of the spine)
  
• Disk degeneration
  
• Certain endocrine diseases
  
• Paget's disease
  
• Polio
  
• Tumors
  

Kyphosis can also be seen in association with scoliosis (an abnormal sideways curvature of the spine seen in children and adolescents). Risk factors are related to the causes.

Symptoms

• Mild back pain
  
• Fatigue
  
• Tenderness and stiffness in the spine
  
• Round back appearance
  
• Difficulty breathing (in severe cases)
  

Signs and tests

Physical examination by a health care provider confirms the abnormal curvature of the spine. The doctor will also look for any neurologic changes (weakness, paralysis, or changes in sensation) below the level of the curve.

A spine X-ray will be done to document the severity of the curve and allow serial measurements to be performed.

Occasionally, pulmonary function tests may be used to assess whether the kyphosis is affecting breathing.