The spine has to have its vertebrae aligned and healthy curves in place to function optimally. Spinal function refers to the spine's flexibility, strength, and ability to handle stress. Kyphosis causes an excessive spinal curve in the spine's coronal plane, while scoliosis causes the development of an unhealthy spinal curve in the sagittal plane; continue reading to find out more.
Healthy spinal function is dependent upon healthy spinal curves. Kyphoscoliosis involves two separate spinal conditions occurring simultaneously: kyphosis and scoliosis. One curve will bend unnaturally from front to back and the other will bend to the side and rotate.
Spinal health is important for quality of life; let's start with why.
A healthy spine can be one of those things we take for granted, until an injury or developing a spinal condition highlights how important it is for quality of life.
The spine helps us move flexibly, practice healthy posture, remain upright, protects the heart and lungs, and works with the brain to form the central nervous system (CNS).
As the central nervous system is what allows the brain to communicate with the rest of the body, the spine is involved in how the body functions in many different ways.
A healthy spine will have its characteristic healthy curvature types in place in each of the main spinal sections: the cervical spine (neck), thoracic spine (middle/upper back), and the lumbar spine (lower back).
When the spine's natural and healthy curves are in place, the bones of the spine (its vertebrae), are aligned and stacked on top of one another in a straight and neutral alignment; this facilitates optimal spinal function.
So what happens when the spine loses one or more of its healthy curves? There are a number of conditions that cause this to happen; two common ones are kyphosis and scoliosis, and in cases of kyphoscoliosis, they occur at the same time.
Anatomical planes are hypothetical planes that refer to the location of structures within the human body, and there are three: the coronal plane, the sagittal plane, and the transverse plane.
Kyphosis involves the development of an excessive kyphotic curve in the thoracic spine; a kyphotic curve is a forward-bending spinal curve that causes the middle and upper back to round forward excessively, commonly referred to as roundback, due to its abnormal hunch.
A healthy range of kyphosis would fall between 20 and 50 degrees, with a person's degree of kyphosis commonly considered excessive at 50+ degrees.
So a kyphotic curve develops in the coronal plane: viewing the spine from the front and/or back
Scoliosis involves the development of an unnatural sideways bending and rotating spinal curvature, and it can affect any spinal section.
Scoliosis causes postural changes and pain once it becomes compressive: when skeletal maturity is reached.
Skeletally immature patients have the lengthening motion of growth to counteract compression, and this is why pain control is not a common focus in childhood scoliosis treatment.
So a scoliotic curve develops in the sagittal plane; picture viewing the spine from either side.
A diagnosis of kyphoscoliosis would mean an unnatural curvature of the spine has developed in both the coronal and sagittal planes.
The causes of kyphoscoliosis will vary based on the condition type in question.
There are three types of kyphosis: postural, Scheuermann's, and congenital kyphosis.
There are four main types of scoliosis: idiopathic scoliosis, neuromuscular, degenerative, and congenital scoliosis.
Postural kyphosis is caused by chronic poor posture and is the simplest to treat because it's not structural.
In postural conditions, a change in body positioning can alter the curve.
Structural conditions involve a structural abnormality within the spine itself so they are more complex to treat and can't be altered by movement alone.
Scheuermann's kyphosis is a structural condition that involves misshapen spinal vertebrae interfering with the spine's ability to maintain its natural curves and alignment; this commonly involve vertebral bodies being more triangular in shape than rectangular, causing the vertebrae to wedge forward and the thoracic spine to bend forward excessively.
Congenital kyphosis is also structural and affects babies whose spines have malformed in utero; babies are born with congenital kyphosis.
Congenital kyphosis often involves an issue in the spinal column that can include vertebrae not forming properly, multiple vertebrae fusing into one solid bone, instead of separate vertebral bodies, and the condition tends to get worse with growth.
The causes of scoliosis will vary based on the condition type.
The most common type of scoliosis is idiopathic scoliosis, and this means cause unknown; this type accounts for approximately 80 percent of known diagnosed cases.
The remaining 20 percent of scoliosis cases have known causes, and these include neuromuscular scoliosis, degenerative scoliosis, and congenital scoliosis.
Neuromuscular scoliosis is caused by the presence of larger neuromuscular diseases like spina bifida, cerebral palsy, or muscular dystrophy disrupting communication between the brain, the spine, muscles, and/or connective tissues that support and stabilize the spine.
Degenerative scoliosis is caused by natural age-related spinal degeneration so tends to affect older adults.
Like congenital kyphosis, congenital scoliosis is caused by a spine that doesn't develop properly while in utero, and many of these babies present with additional congenital abnormalities so need to be examined carefully.
When kyphosis and scoliosis develop together, this means there are two unnatural spinal curves in the spine: one that bends excessively forwards and one that bends excessively to the side and rotates.
Connective tissue diseases can affect bone health and are associated with the development of kyphoscoliosis, examples of which include Marfan syndrome and Ehlers Danlos syndrome.
Symptoms of kyphoscoliosis will vary based on a number of factors: patient age, condition type, severity, and curvature location.
Symptoms of mild kyphoscoliosis can be subtle, but even when the two curves are small, as there is more than one and they are in different planes, symptoms tend to be noticeable.
Symptoms of moderate kyphoscoliosis and severe kyphoscoliosis can be overt and become more so as the condition progresses; progression is triggered by growth.
Kyphosis Symptoms
Symptoms of kyphosis involve postural changes that give the spine a rounded-forward (slouching) appearance and pain.
Kyphosis pain can involve the muscles, back pain, and radiating pain due to nerve compression.
Scoliosis Symptoms
Symptoms of scoliosis can involve postural changes like uneven shoulders and uneven hips as the uneven forces of scoliosis disrupt the body's symmetry.
Scoliosis doesn't become compressive until skeletal maturity has been reached, at which point pain can become a noticeable symptom that can range from mild to chronic pain; scoliosis pain can also involve the muscles, the back, and pain radiating into the extremities.
If left untreated, kyphoscoliosis is likely to progress over time, disrupting spinal stability and balance, and affected individuals can benefit from proactive treatment that addresses the condition's underlying cause.
Here at the CLEAR Scoliosis Institute, conservative non-surgical intervention is our focus and it's chiropractic-centered and proactive.
I can't guarantee treatment results for any of my patients, but being proactive means starting treatment immediately following a diagnosis; this is when conditions are at their mildest and likely to be at their most responsive.
The benefits of early detection are only available to patients whose treatment providers respond immediately by actively treating the condition.
Treatment at the Institute is highly customized and case-specific, but in typical cases of kyphoscoliosis, the first step is determining which condition is more severe, the kyphosis or the scoliosis, and establishing the major and minor curve.
In most cases, the larger unnatural curvature of the spine will be the focus of treatment initially, and conservative treatment for both kyphosis and scoliosis can involve physical therapy, scoliosis-specific exercises and other therapies, a number of chiropractic techniques and adjustments, corrective bracing when appropriate, and rehabilitation.
Curvature Reductions
Reducing the size of the unnatural spinal curves on a structural level is the focus of treatment because this is addressing the condition's underlying structural nature: the cause of the condition's symptoms.
Curvature reductions are worked towards through chiropractic care that can realign the spine.
When kyphosis is postural, which is the most common type, it can generally be treated with physical therapy and posture correction.
Physical therapy can also be a key facet of treatment for structural conditions by strengthening the spine's surrounding muscles so they can provide more spinal support/stability; it can also help prepare the spine for treatment, restore muscle balance, improve posture, and provide pain relief.
Corrective bracing is a common component of treating scoliotic and kyphotic curves in children because growing spines are more malleable and can be pushed into a healthier position, and for adults, bracing is more about short-term pain management and improving spinal stability.
Rehabilitation is about continuing to heal and stabilize the spine through a combination of chiropractic care and custom-prescribed exercises and stretches.
When it comes to the surgical management of kyphoscoliosis, this can involve spinal fusion surgery that addresses unnatural spinal curves by fusing their most-tilted vertebrae together and attaching hardware to the spine to hold it in place.
Surgical correction can be costly, risky, and invasive, and non surgical methods provide a more proactive and natural approach to preventing further progression of spinal abnormalities.
The spine is an important structure of human anatomy, and as such, it can be vulnerable to a number of injuries and spinal conditions.
Kyphoscoliosis is diagnosed through a combined physical examination and X-ray results, and once a diagnosis is reached, potential physical limitations can be minimized through a proactive treatment approach.
As a CLEAR-certified scoliosis chiropractor, I have experience treating a wide range of spinal conditions, kyphosis, scoliosis, and kyphoscoliosis included.
Again, while there are no treatment guarantees, when a spinal deformity is addressed proactively, even severe kyphoscoliosis symptoms can be improved by addressing their underlying cause: the kyphoscoliosis itself.
Impacting conditions on a structural level is the focus of conservative treatment, and improving core muscle strength can help hold structural results and prevent vertebrae from shifting out of alignment with the rest of the spine.
When the spine is curved unnaturally, in severe cases, and/or when it's left untreated, complications can develop including disruptions to lung function, pulmonary hypertension, neurologic deficits, neurological issues, migraines, and digestive issues.
Spinal deformities can be addressed through surgical correction or conservative non surgical methods, and with early detection and a proactive treatment approach, an abnormal curvature of the spine can be reduced, along with the condition's effects.
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