Kyphosis and Spinal Deformity

Kyphosis is an excessive forward curve of the spine. When severe, it causes pain, functional limitation, and a stooped posture that progressively worsens without treatment.

OVERVIEW

What is kyphosis?

Kyphosis refers to an abnormal increase in the forward rounding of the thoracic spine — the mid-back. While a normal thoracic spine has a natural gentle kyphosis of 20 to 40 degrees, pathological kyphosis exceeds this range and can cause pain, functional limitation, and progressive deformity.

Postural kyphosis — the most common type — develops from habitual poor posture and responds to physical therapy. Scheuermann’s kyphosis is a structural deformity caused by abnormal vertebral growth during adolescence, producing a rigid forward curve that does not correct with position changes. Post-surgical kyphosis develops as a complication of prior spine surgery, particularly after laminectomy or inadequately balanced fusion.

Dr. Enguidanos is a fellowship-trained spine surgeon at HCA Florida Twin Cities Hospital in Niceville, Florida, with specialized training in spinal deformity correction including kyphosis surgery. He serves patients throughout the Florida Panhandle and Gulf Coast who have been told their deformity is too advanced for correction.

SYMPTOMS

Common symptoms.

Progressive forward-leaning posture or hunched appearance
Mid-back pain, often worse with prolonged standing or sitting
Fatigue from the muscular effort required to maintain upright posture
Visible rounded back — more pronounced when bending forward
Difficulty standing fully upright or looking straight ahead
Chest tightness or shortness of breath in severe cases
Leg pain or weakness if kyphosis causes spinal stenosis
Loss of height over time with progressive deformity

CAUSES AND RISK FACTORS

What causes it.

Postural — habitual slouching, most common in adolescents
Scheuermann’s disease — abnormal vertebral end plate development during growth
Osteoporosis — vertebral compression fractures causing progressive forward collapse
Post-surgical — inadequate sagittal balance after prior spine surgery
Ankylosing spondylitis — inflammatory arthritis fusing the spine in a forward posture
Neuromuscular conditions — muscle weakness allowing progressive kyphotic collapse
Congenital — abnormal vertebral formation causing kyphosis from birth

WHEN TO SEEK CARE

When to call us.

Seek evaluation when kyphosis is progressing on serial X-rays, when pain is not responding to conservative treatment, when you have difficulty standing upright or your quality of life is significantly affected, or when you notice worsening posture despite physical therapy.

Scheuermann’s kyphosis over 75 degrees in an adolescent or over 70 degrees with pain in an adult generally warrants surgical evaluation. Post-surgical kyphosis causing sagittal imbalance — where you cannot stand upright without bending your knees — requires prompt evaluation as it typically worsens over time without intervention.

Related Conditions

Quick Facts

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DR. ENGUIDANOS'S APPROACH

Sagittal balance is the goal. Not just correcting the curve.

Full-Length Standing X-Rays

Kyphosis correction requires understanding the entire spinal alignment from the skull to the pelvis. Dr. Enguidanos reviews full-length standing X-rays to measure the deformity and plan the correction required.

Conservative Care First

Postural kyphosis responds well to physical therapy and postural retraining. Even structural kyphosis is managed conservatively initially unless surgery is clearly indicated.

Osteotomy When Required

Rigid kyphosis — including Scheuermann’s and post-surgical deformity — requires osteotomies to allow correction. Dr. Enguidanos performs pedicle subtraction osteotomies and vertebral column resections for severe cases.

Fellowship Expertise

Kyphosis correction is among the most technically demanding procedures in spine surgery. Dr. Enguidanos’s fellowship training at the University of Colorado under Dr. Thomas Lowe specifically covered complex deformity correction of this type.

SURGICAL OPTIONS

How Dr. Enguidanos treats it.

The appropriate procedure depends on the severity of your condition, your health, and your goals. Dr. Enguidanos evaluates every patient individually.

DEFORMITY

Posterior Spinal Fusion

Pedicle screw instrumentation and fusion to correct and stabilize kyphotic deformity. The foundation of most kyphosis surgical correction.

DEFORMITY

Osteotomy

Controlled bone cuts that allow three-dimensional realignment of rigid kyphotic deformity. Pedicle subtraction osteotomy and vertebral column resection for severe cases.

FRACTURE

Vertebroplasty and Kyphoplasty

For kyphosis caused by osteoporotic compression fractures, cement augmentation stabilizes acute fractures and may restore vertebral height.

RECOVERY

What to expect after surgery.

3-5 Days

Hospital Stay

Complex kyphosis corrections require a longer hospital stay for pain management and early mobilization under physiotherapy supervision.

4-6 Weeks

Early Recovery

Walking is encouraged early. Most patients are mobile within days and begin supervised rehabilitation within the first month.

3-6 Months

Functional Recovery

Return to most daily activities with ongoing physical therapy to strengthen the muscles supporting the corrected alignment.

12-18 Months

Full Recovery

Fusion maturation and full functional recovery occur over twelve to eighteen months. Standing posture improvement is often dramatic.

PATIENT STORY

★★★★★

"At sixty-two I could not stand upright without pain. Dr. Enguidanos corrected my kyphosis with an osteotomy. The difference in my posture and quality of life has been remarkable."

WILLIAM R.

Kyphosis Correction with Pedicle Subtraction Osteotomy | Niceville, Florida

Ready to discuss your spine?

(850) 729-1444

Kyphosis and Spinal Deformity.