Natural Spinal Curves
The thoracic spine usually has a kyphotic curve and it is here where more severe symptoms of extreme kyphosis are often seen. The lumbar spine and cervical spine had lordotic curves and the spine overall has an inverted ‘s’ shape when looked at from the side. The curvature of the spine in the neck can become abnormal following direct neck trauma, degenerative bone disease, degenerative disc disease, arthritis in the cervical spine, cervical spondylolisthesis (where spinal segments slip out of place), and even due to postural kyphosis. Sufferers may begin to develop an array of symptoms connected with kyphosis in the neck, some minor and some more severe and disabling.
Symptoms of Cervical Kyphosis and Stenosis
Kyphosis changes the appearance of the neck and back, with some patients experiencing severe deformity. As the spine changes structure it can cause neurological dysfunction and pain and paraesthesia in the neck, arms and hands. Any kyphotic curve in the cervical spine is abnormal as cervical lordosis is its natural state. Where kyphosis is severe it can cause the spinal canal to become narrower and may even lead to spinal cord compression. As this problem persists the likelihood of muscle weakness and wasting increases as the nerves innervating the muscles cannot properly function and numbness gives way to paralysis.
Severe Stenosis in the Neck
In some cases the kyphosis is limited to one or two spinal segments only and its manifestations are minor, barely changing the appearance at all. Other cases are more severe, involving most of the cervical vertebrae and significantly altering the appearance and function of the neck.
Types of Cervical Spinal Kyphosis
Congenital kyphosis may also arise and is usually treated early in life with back surgery to correct the abnormality. This type of neck surgery is intended to halt the progression of the undesirable curve and is usually successful in doing so. In these cases, conservative treatment for kyphosis is rarely helpful and patients require continual assessment to ensure action is taken when needed to prevent further degeneration. Traumatic causes of cervical kyphosis may be able to be corrected with conservative methods as the abnormal curve could be due to a compression fracture of the vertebrae, ligament damage or other condition that could benefit from realignment, spinal support and adequate healing time. A compression fracture that is not addressed properly may heal in a wedge-shape, thus distorting the spine.
When Back Surgery Causes Kyphosis
Iatrogenic cervical kyphosis is also a possibility and is connected to medical treatment such as surgery. Laminectomy is a common culprit behind cervical kyphosis, especially in children, as this changes the stability and rigidity of the spine. Joint damage during surgery may also lead to instability and iatrogenic kyphosis in the neck as can a short fusion where too few segments of the spine are fused and the adjacent segments begin bending over. Failed back surgery syndrome and pseudoarthrosis is another possible trigger for cervical kyphosis symptoms.
Less Common Causes of Cervical Kyphosis
There are a variety of other, less common causes, of cervical kyphosis including spinal tumors, ankylosing spondylitis, and radiation therapy for neck cancer. Whatever the cause of the abnormal curvature of the spine, the symptoms are usually the same as the basic underlying structures of the neck are affected similarly. Some of these symptoms of cervical kyphosis include:
- Mechanical neck pain
- reduced range of motion (difficulty looking upwards for any length of time)
- problems with nerve roots and nerve signalling
- weakness in the arms and even the legs
- weakened grip and loss of manual dexterity
- walking difficulties
- urinary and fecal incontinence
- paralysis from the neck down
Treating Cervical Kyphosis
The severity of the symptoms depends largely on how early the kyphosis is observed and when treatment begins as it is usually easier to catch and slow down progressive spinal issues than to rectify significant deformity of the spine. Regular diagnostic imaging and assessment is important to monitor progress and patients with cervical kyphosis symptoms should expect a range of questions and tests to determine how severe their condition is and whether surgery is necessary.