Sections View Full Chapter Figures Tables Videos Annotate Full Chapter Figures Tables Videos Supplementary Content ++ Scheuermann’s diseaseJuvenile disk diseaseRoundbackHunchbackPostural kyphosis ++ 737 Curvature of spine737.0 Adolescent postural kyphosis737.1 Kyphosis (acquired)737.10 Kyphosis (acquired) (postural)737.11 Kyphosis due to radiation737.12 Kyphosis postlaminectomy737.19 Other kyphosis acquired ++ M40.00 Postural kyphosis, site unspecifiedM40.209 Unspecified kyphosis, site unspecifiedM96.2 Postradiation kyphosisM96.3 Postlaminectomy kyphosisM40.299 Other kyphosis, site unspecified ++ 4A: Primary Prevention/Risk Reduction for Skeletal Demineralization14B: Impaired Posture4E: Impaired Joint Mobility, Motor Function, Muscle Performance, and ROM Associated with Localized Inflammation6E: Impaired Ventilation and Respiration/Gas Exchange Associated With Ventilatory Pump Dysfunction or Failure +++ Description ++ Excessive posterior curvature of the thoracic spineScheuermann’s disease (juvenile disk disease) caused by wedging of several vertebraePostural kyphosis: from slouching or poor postureCongenital kyphosis: under-development of the spinal column Gibbus deformity: structural kyphosis from tuberculosisTypes of kyphotic deformitiesRound backDecreased pelvic inclination with thoracolumbar or thoracic kyphosisCaused by tightness in soft tissues from prolonged postural changeCompensatory mechanism to maintain body’s center of gravity Hunchback (hump back) Gibbus: localized, sharp, posterior angulationStructural causeAnterior wedging of 1 to 2 thoracic vertebrae bodiesWedging may be caused by fracture, tumor, bone diseasePelvic inclination usually normal Flat-back Decreased pelvic inclinationThoracic spine remains mobileKyphosis presentDoes not have appearance of excessive kyphotic curveDowager's hump Secondary to postmenopausal osteoporosisAnterior-wedge fractures of several upper or middle thoracic vertebrasContributes to decrease in height +++ Essentials of Diagnosis ++ Diagnosis usually made by clinical examinationCan be an independent diagnosis, not associated with a disease processCobb angle measures degree of scoliosis +++ General Considerations ++ Respiratory problems secondary to changes in rib-cage space +++ Demographics ++ Women affected more frequently than men due to postmenopausal alteration +++ Signs and Symptoms ++ Pain and stiffness at rest/sleepInability to sleep supineStiffness in the spinePain in the upper and middle thoracic spineTight pectoral, hamstring, hip flexor musclesFatigueOverstretched and weak middle-/lower-trapezius and rhomboid musclesLocal tenderness with palpation seen in vertebral compression fracturesScapular wingingForward head positioningWeak spinal extensorsTight cervical extensors Weak cervical flexorsRespiratory problems +++ Functional Implications ++ Pain while in supine position without head-of-bed elevationDifficulty reaching overheadDecreased endurance secondary to impaired pulmonary capacity +++ Possible Contributing Causes ++ Poor posturePoor nutrition: ricketsOsteoporosisDegeneration of intervertebral discsVertebral compression fracturesEndocrine disordersArthritisPaget’s diseaseMetastatic tumorInfectionScheuermann’s diseaseAnkylosing spondylitisSpina bifidaPolioNeurofibromatosisTuberculosisSpondylolisthesisCerebral palsy (pediatric) +++ Differential Diagnosis ++ Vertebral compression fractureSpinal stenosisEhlers-Danlos syndromePott’s disease +++ Imaging ++... Your Access profile is currently affiliated with [InstitutionA] and is in the process of switching affiliations to [InstitutionB]. Please select how you would like to proceed. Keep the current affiliation with [InstitutionA] and continue with the Access profile sign in process Switch affiliation to [InstitutionB] and continue with the Access profile sign in process Get Free Access Through Your Institution Learn how to see if your library subscribes to McGraw Hill Medical products. Subscribe: Institutional or Individual Sign In Error: Incorrect UserName or Password Username Error: Please enter User Name Password Error: Please enter Password Sign in Forgot Password? Forgot Username? Sign in via OpenAthens Sign in via Shibboleth You already have access! Please proceed to your institution's subscription. Create a free profile for additional features.