Scoliosis with Kyphosis: What You Should Know

The spine’s healthy curves are important; they make the spine stronger, more flexible, facilitate shock absorption and the spine’s alignment. If an unhealthy spinal curve develops, the spine’s health, balance, and function can be disrupted; it’s important to restore the spine’s balance and alignment.

Scoliosis and kyphosis can occur at the same time; this is known as kyphoscoliosis (KS). Scoliosis causes the spine to develop an unnatural side-to-side curve, while kyphosis involves the development of an excessive front-to-back curve in the middle/upper spine.

Scoliosis and kyphosis both involve the development of unhealthy spinal curves, and when they occur together, treatment needs can be complex.

What is Scoliosis?

Scoliosis is a prevalent spinal condition that involves the development of an unnatural lateral spinal curve with rotation, so the spine curves to the side unnaturally and twists.

Scoliosis can develop in any spinal section but is most common in the thoracic spine (middle/upper back).

As a progressive condition, scoliosis is incurable and requires ongoing treatment, and while some cases are stable, most will increase in severity over time, and scoliosis that’s left untreated can develop complications.

The main trigger for scoliosis progression is growth, so childhood scoliosis has to be managed proactively.

Ranging widely in severity, scoliosis can be mild, moderate, severe, or very severe, and the best way to prevent progression is a proactive and customized treatment plan.

Scoliosis affects all ages, but is most often diagnosed in adolescents as adolescent idiopathic scoliosis (AIS).

Most cases involve idiopathic scoliosis: no known cause. Approximately 80 percent of scoliosis cases are idiopathic, with the remaining 20 percent associated with known causes: neuromuscular conditions, degenerative changes in the spine, and congenital malformations.

Scoliosis has an underlying structural nature, so treatment needs to impact cases on a structural level and often involves a combination of scoliosis-specific exercise plans, corrective bracing, and scoliosis-specific chiropractic care, and in some severe cases, surgical correction may be necessary.

The main symptoms of scoliosis include poor posture (asymmetrical changes), disruptions to balance, coordination, gait, and in adults, back and radiating pain is the main symptom.

What is Kyphosis?

Kyphosis refers to the natural forward-bending curve of the thoracic spine (middle/upper back), and while peoples’ degrees of kyphosis can vary within a healthy range, if kyphosis becomes excessive, the curve becomes atypical and problematic.

When the thoracic spine develops an abnormal curvature that bends forward excessively, this is known simply as kyphosis and/or hyperkyphosis.

The main symptoms of hyperkyphosis include a noticeable arch in the upper back that causes the shoulders to also round forward excessively; the appearance is known as roundback.

Back and radiating pain is also common, particularly as conditions are progressing during growth.

Kyphosis is often diagnosed in adolescents and can get worse with growth. Kyphosis also has different types: postural kyphosis, Scheuermann’s Kyphosis, and congenital kyphosis.

Cases of postural kyphosis are the simplest to treat because they’re nonstructural and are caused by chronic poor posture that can be corrected with changes to body position and core strengthening through physical therapy.

Scheuermann’s kyphosis and congenital kyphosis are more complex to treat because they are structural in nature so are caused by abnormalities within the spine itself; the curve is rigid and can’t be impacted through changes in position.

Scheuermann’s kyphosis can be treated with physical therapy and corrective bracing, but in severe cases and cases of congenital kyphosis, surgical intervention may be necessary to address the structure of misshapen vertebral bodies.

And what if scoliosis and kyphosis occur together?

Kyphoscoliosis

A single abnormal curvature of the spine can disrupt its overall biomechanics and health, and in cases of kyphoscoliosis, there is more than one unnatural spinal deformity affecting the spine.

While scoliosis affects the spine in the sagittal plane with an unnatural lateral spinal curvature, while kyphosis affects the spine in the coronal plane with a forward-bending curve.

In cases of kyphoscoliosis, the spine will take on an S-shaped curve or a C-shaped curve that causes an excessive rounding-forward of the upper back.

In addition to the physical changes of a rounded-forward posture, uneven shoulders and hips, pain, fatigue, and breathing difficulties can also develop. The more severe the unnatural spinal curves are and/or become, the more disruptive the symptoms can become.

Kyphoscoliosis is diagnosed through a physical examination and X-ray results that confirm the presence of an unnatural sideways spinal curve (scoliosis) with rotation and an excessive front-to-back curve (kyphosis).

A functional assessment is needed to determine if there is neurological involvement. Risk factors include age, gender, and a family history of kyphosis and/or scoliosis.

Kyphoscoliosis Treatment Options

Any disruption to the spine’s health and function can cause widespread effects, especially when the changes are progressive and can increase in severity over time.

When postural, unnatural spinal curves can typically be addressed with physical therapy and lifestyle guidance, but when an abnormal curvature of the spine is structural, treatment plans need to be comprehensive and customized.

When the spine has more than one unnatural spinal curve, the priority is determining which curve is more severe, and that curve is addressed first as the goal of treatment is to restore as much of the spine’s healthy curves as possible to improve the spine’s alignment, balance, stability, and to improve postural variation, pain, and respiratory issues.

Specialized corrective and rehabilitative exercise plans that can include Schroth exercises and SEAS (scientific exercise approach to scoliosis) work towards preventing further progression, improving a patient’s posture, respiratory function, pain, and strengthening core and back muscles.

The spine needs support from its surrounding muscles, and a strong core supports healthy posture and movement patterns. Postural health and spinal health shape one another, so teaching patients postural awareness is crucial so they can sustain treatment results and hold corrections.

Corrective bracing is particularly effective on growing spines and can stabilize the torso and spine by maintaining its straight alignment and the torso’s upright posture.

Corrective braces like the ScoliBrace® and the KyphoBrace® are fully customized to address the specifics of a patient’s posture and spinal condition, and they also help with pain management and retraining the brain and body to support the spine’s new position while in and out of the brace.

Bracing can be prescribed for full-time or part-time wear, but in most cases of adolescent kyphoscoliosis, full-time bracing is more effective.

The Scoliosis Center of Utah also offers a highly-specialized type of chiropractic care: Chiropractic BioPhysics®, and when appropriate, manual adjustments and a variety of chiropractic techniques can complement the effects of physical therapy and corrective bracing by working towards improving the position of the most tilted vertebrae.

Severe kyphoscoliosis may require spinal fusion surgery, so the goal of proactive treatment is to prevent mild and moderate cases from becoming severe and requiring invasive operative management.

Conclusion

What you need to know about Kyphoscoliosis is the sooner it’s diagnosed and treated, the better. No treatment outcome can be guaranteed, but with progressive conditions like kyphoscoliosis, there are a number of advantages to starting treatment early.

With early diagnosis and intervention, curves can be proactively treated with a customized conservative treatment plan combining the potential of rehabilitative exercise, corrective bracing, and chiropractic care.

Here at the Center, the priority is preserving spinal health and function through improving its alignment, balance, and improving body posture.

Spinal abnormalities can cause a number of effects from postural and mobility changes to pain, and a single unnatural spinal curve can disrupt the health of the entire spine.

The spine’s healthy curves keep it balanced and aligned, and when it comes to kyphoscoliosis patients with more than one unhealthy spinal curve, treatment needs are complex and require a comprehensive and customized treatment approach.