Kyphosis classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Kyphosis, an abnormal curvature of the spine, is classified into postural, Scheuermann's, congenital, nutritional and gibbus types.

Classification

There are several kinds of kyphosis (ICD-10 codes are provided):

Postural kyphosis (M40.0)

The most common type, normally attributed to slouching, can occur in both the old and the young. In the young, it can be called 'slouching' and is reversible by correcting muscular imbalances. In the old, it may be called hyperkyphosis or dowager’s hump. About one third of cases have vertebral fractures. Otherwise, the aging body tends towards a loss of musculoskeletal integrity, and kyphosis can develop due to aging alone.

Scheuermann's kyphosis (M42.0)

Scheuermann's kyphosis is significantly worse cosmetically and can cause pain. It is considered a form of juvenile osteochondrosis of the spine, and is more commonly called Scheuermann's disease. It is found mostly in teenagers and presents a significantly worse deformity than postural kyphosis. A patient suffering from Scheuermann’s kyphosis cannot consciously correct posture. The apex of the curve, located in the thoracic vertebrae, is quite rigid. The patient may feel pain at this apex, which can be aggravated by physical activity and by long periods of standing or sitting. This can have a significantly detrimental effect on their lives, as their level of activity is curbed by their condition; they may feel isolated or uneasy amongst peers if they are children, depending on the level of deformity. Whereas in postural kyphosis the vertebrae and disks appear normal, in Scheuermann’s kyphosis they are irregular, often herniated and wedge shaped over at least three adjacent levels. Fatigue is a very common symptom, most likely because of the intense muscle work that has to be put into standing and/or sitting properly. The condition seems to run in families.

Congenital kyphosis (Q76.4)

Congenital kyphosis can result in infants whose spinal column has not developed correctly in the womb. Vertebrae may be malformed or fused together and can cause further progressive kyphosis as the child develops. . Surgical treatment may be necessary at a very early stage and can help maintain a normal curve in coordination with consistent follow ups to monitor changes. However, the decision to carry out the procedure can be very difficult due to the potential risks to the child. A congenital kyphosis can also suddenly appear in teenage years, more commonly in children with cerebral palsy and other neurological disorders.

Nutritional kyphosis

Nutritional kyphosis can result from nutritional deficiencies, especially during childhood, such as vitamin D deficiency (producing rickets), which softens bones and results in curving of the spine and limbs under the child's body weight.

Gibbus deformity

Gibbus deformity is a form of structural kyphosis, often a sequela to tuberculosis.