Kyphosis affects the sagittal plane, or side view. The thoracic spine should have a gentle rounding behind the shoulders. Normal thoracic kyphosis ranges from 20° to 40° when viewed from the side. If the curvature grows larger than that, a kyphosis is present. Diagnosis is based on physical examination and x-ray evaluation. Treatment depends on the patient's age, the size of the curve and symptoms the patient may be experiencing.
Spine surgery for kyphosis is recommended for patients whose curvatures continue to progress or cause symptoms despite non-operative treatment. Corrective surgery for thoracic kyphosis is usually recommended when curves are larger than 80° to 90° when measured on x-rays. Kyphosis can extend into the mid or lower back and in those cases surgery is recommended for curves larger than 60° to 70° of kyphosis. Surgery is also an option for patients with disabling back pain or when kyphosis leads to compression of the spinal cord or nerves.
The goal of spinal reconstruction surgery is to decrease the patient's pain and to place the spine in a more natural position. Most commonly this surgery is performed through a posterior approach in the back of the spine. During the surgery, spinal implants including rods and screws are placed next to the spine. These implants correct the spinal deformity and stabilize the spine in its new position while the spine fuses, or mends, together. These bones ultimately heal into one solid piece for spinal stability and prevention of further curve progression. Complications may occur but are not common. The majority of patients are satisfied with their pain relief and the results of their surgery. It is important that all patients are physically and psychologically prepared. All patients should stop smoking prior to any surgery, as smoking is extremely detrimental to your spine health, potential bone healing and successful surgical outcomes. Please review additional details with your surgeon prior to your surgery.
This patient is a 64-year-old man with severe progressive kyphosis. He lost the ability to stand erect and to hold his head upright to look forward while walking. He suffered from severe neck, thoracic and low back pain even when taking heavy doses of pain medicine. The patient underwent staged spinal reconstruction with kyphosis correction with Dr. Good at the Virginia Spine Institute and has noted significant improvement in his pain after surgery. He is now able to stand up straight and look forward while walking. X-rays taken before surgery show >100° kyphosis from the neck down to the low back and x-rays after surgery show normal spinal alignment.
“This Patient's Condition Was Very Severe And The Surgery Performed Is Not Common; However, His Story Serves As An Inspiring Example Of The Power Of Spinal Deformity Surgery To Help Someone Who Is Suffering From Terrible Pain And Disability.”
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