From the Guidelines
Fixed spinal kyphosis is defined as a spinal deformity with a kyphosis of 15% or more, which is a permanent, abnormal forward curvature of the spine that cannot be corrected voluntarily. This condition is characterized by an excessive outward curve in the thoracic spine, creating a rounded or hunched appearance, and remains present regardless of position or effort to straighten the spine 1. The definition of spinal deformity, including kyphosis, is crucial in the management of vertebral compression fractures, as it can contribute to impaired mobility and physical functioning. According to the study, spinal deformity may be defined as 15% kyphosis, 10% scoliosis, 10% dorsal wall height reduction, or vertebral body height loss 20% 1.
Key Characteristics of Fixed Spinal Kyphosis
- Permanent, abnormal forward curvature of the spine
- Cannot be corrected voluntarily
- Excessive outward curve in the thoracic spine
- Creates a rounded or hunched appearance
- Remains present regardless of position or effort to straighten the spine
- Can cause chronic pain, respiratory difficulties, neurological symptoms, and reduced mobility
Importance of Early Diagnosis and Intervention
Early diagnosis and intervention are crucial in preventing progression and managing symptoms effectively. Treatment approaches depend on severity and underlying cause, potentially including pain management, physical therapy, bracing, and in severe cases, surgical intervention such as spinal fusion or vertebral wedge osteotomy to realign the spine. The study highlights the importance of timely intervention, as conservative medical treatment does not prevent further collapse and does not prevent kyphosis, and approximately 1 in 5 patients with osteoporotic VCFs will develop chronic back pain as a result of the fracture 1.
From the Research
Definition of Fixed Spinal Kyphosis
- Fixed spinal kyphosis is a rigid structural deformity of the thoracic spine, defined radiographically as three or more contiguous vertebrae with at least 5° of wedging anteriorly 2, 3.
- The deformity is characterized by anterior wedging of adjacent thoracic vertebral bodies, with secondary radiographic findings of Schmorl's nodes, endplate narrowing, and irregular endplates 3.
- Fixed spinal kyphosis can be classified as Scheuermann's kyphosis, which is a specific type of thoracic kyphosis that affects adolescents and adults 2, 3.
Key Characteristics
- The diagnosis of fixed spinal kyphosis is based on radiographic findings, including the degree of wedging and the presence of secondary radiographic features 2, 3.
- The severity of the deformity can be measured using various parameters, including the Cobb angle and the degree of kyphosis 4.
- Fixed spinal kyphosis can be associated with various symptoms, including pain, neurologic compromise, and cosmesis 2, 3.
Related Conditions
- Osteoporotic vertebral fractures can be associated with fixed spinal kyphosis, and bracing may be used as a treatment option for these fractures 5.
- Lumbar kyphosis, rather than thoracic kyphosis, has been shown to be associated with postural sway and an increased risk of falls in patients with osteoporosis 6.