In patients who are in the acute phase of their injury, the surgeon usually performs a posterior spinal fusion, approaching the area through the back. Surgical treatment for post-traumatic kyphosis is accomplished through spinal fusion and stabilization with instrumentation.
“The goal of surgery is to alleviate pain, restore the spine to proper alignment, and improve neurologic function,” explains Dr. However, if the kyphosis is significant, surgery may be recommended to avoid the long-term consequences of kyphosis, including pain, hyperextension, and overuse injuries from lordosis in the neck and the lower back. If non-surgical treatment is recommended, the orthopedist will put the patient in a brace to support the spine as it heals, and physical therapy is initiated to alleviate pain, strengthen surrounding muscles, and improve posture. Treatment recommendations are based on a variety of factors, including the type of fracture (some kinds of fractures make the patient more susceptible to kyphosis), the site of the fracture, the extent of angulation in the affected part of the spine, and the size of the patient. Treatmentīecause post-traumatic kyphosis can progress if the injury heals without intervention, the goal for patients in the acute phase is to correct the spinal alignment as soon as it is safe to do so. This sensation occurs when the abdominal contents are squeezed against the diaphragm due to the abnormal curve of the spine. Some patients may also develop early satiety, a feeling of fullness that occurs more quickly than normal when eating. “In an attempt to compensate for their kyphosis, patients may also develop abnormal lordosis, an excessive arching of the lower spine and the cervical spine in the neck, and overuse of the muscles to maintain alignment,” Dr. CT scan, if the extent of the patient’s injury is not clear on routine x-ray images and the orthopedist suspects that a fracture-dislocation has occurred.įor those whose injury has healed in an abnormal alignment, back pain may be accompanied by an inability to stand erect, as well as associated neck pain that results from efforts to do so.MRI to assess any encroachment on the nerves that could give rise to related motor or sensory symptoms.X-ray images to determine the presence and type of fracture.Tools used to evaluate the patient include: “Because trauma patients often have multiple injuries, including those affecting the head, neck, and abdomen, it’s important that they undergo a complete evaluation - including a neurologic assessment - before we begin any intervention,” Dr. In patients who are seen immediately following trauma, pain is the primary symptom. Rawlins, MD, an attending orthopaedic surgeon at HSS Spine, describes two types of patients with post-traumatic kyphosis: those who require care in the acute phase, immediately after trauma, and those who seek treatment after the spine has healed in an abnormal alignment. This occurs when fractures of the vertebrae cause wedging and the normally block-shaped vertebrae become angulated, resulting in a spinal deformity, pain, and a limited range of motion.īernard A. In patients with post-traumatic kyphosis, however, the curve may exceed the normal range, usually in a small segment of the spine. [ Image courtesy of When viewed from the side, a curve of the spine that measures between 40-50 degrees is considered to be a normal part of spine alignment. Post-traumatic kyphosis may occur from the lower lumbar spine (in the lower back) to the cervical spine (in the neck).įigure 1: Diagram detailing the sections of the spine, with the neck (cervical) section at the top. The spinal cord runs through the spinal canal, a passage created by the vertebrae. Disks sit between the vertebrae and provide cushioning and protection. To understand the effect of these injuries, it can be helpful to think of the healthy spine as a series of bony blocks, the vertebrae, which are connected by facet joints that permit movement in the spine. When the impact from such events causes fractures and/or dislocation of the vertebrae (disks of the spine), a kyphotic deformity - an abnormal curve of the spine - can develop, especially if the injury is not treated promptly. As its name suggests, post-traumatic kyphosis is a condition that results from serious injury, such as a fall from a height, a motor vehicle accident, a horseback riding accident, or even a bounce off a wave while boating.