Post-Traumatic Kyphosis

Post-traumatic kyphosis occurs most commonly in the mid- to lower-back. Kyphosis of this kind is typically found in patients with severe fractures and neurologic deficits such as quadriplegia or paraplegia.

One example of kyphosis is post-laminectomy kyphosis. In rare instances, the spine will develop a forward bend after a common procedure (laminectomy) used to treat spinal stenosis (pinched nerves) in adults – especially if many levels are decompressed.

Symptoms

Progressive kyphosis can develop when there is major spine injury. This type of kyphosis can result in chronic, disabling pain:

• Spinal muscle fatigue
• Chronic swelling
• Progressive degeneration of the spine
• Pinched nerve(s)
• Problems with sitting balance with severe kyphosis
• Skin alterations in paraplegic patients with severe kyphosis

Evaluation/Diagnostics

• X-ray detects fracture and helps determine the type of fracture.
• MRI evaluates any pressure on the nerves that could cause neurologic and motor symptoms.
• CT scan provides enhanced imaging when x-ray is not sufficient and/or the physician identifies other reasons it is needed; commonly used to evaluate spinal fractures.
• Biopsy can rule out tumors, infection or other conditions as the underlying cause of compression fracture.

Treatment

Nonoperative Treatment

Goals of treatment for kyphosis includes curve correction, spine stabilization, pain alleviation, and improved neurologic function. The treatments shown below do not necessarily take into account the kyphosis patient who has osteoporosis. Numerous medications—e.g., Calcitonin, Forteo (teriparatide)—are now available; while they may decrease the pain, they cannot correct kyphosis. Current treatment options include:

• Physical therapy
• Non-steroidal anti-inflammatory medication.
• Braces to support the spine and decrease muscle spasm

Operative Treatment

If these conservative measures do not help, surgery may be necessary to control pain and improve curvature or decompress nerve roots. Posterior spinal fusion and instrumentation alone is often used to treat more flexible curvatures. Fixed curvatures often require more complex surgery.