Overview
Cervical kyphosis refers to an abnormal forward curvature of the cervical spine, often associated with structural changes in vertebrae, intervertebral discs, and paraspinal musculature, leading to symptoms such as axial neck pain and potential functional impairment 3.Diagnosis
Key Diagnostic Criteria: Radiographic assessment including Cobb's angle measurement, evaluation of C2-7 sagittal vertical axis (SVA), T1 slope, neck tilt (NT), and cervical tilt 3.
Recommended Tests: MRI for detailed assessment of spinal cord abnormalities, disc herniations, and vertebral wedging 4.
Grading: Classification into global and regional types based on sagittal alignment parameters 3.Management
First-Line Treatments: Conservative management including physical therapy focusing on strengthening paraspinal muscles and improving posture 3.
Adjunctive Treatments: Surgical intervention for severe cases, utilizing devices like anterior distractors for intraoperative correction 5.
Pain Management: Nonsteroidal anti-inflammatory drugs (NSAIDs) for symptomatic relief of axial neck pain 3.Special Populations
Pediatrics: Limited specific data; management focuses on conservative approaches initially 2.
Elderly: Increased risk of comorbidities affecting treatment choices; MRI screening recommended for surgical planning to identify neural axis abnormalities 4.Key Recommendations
Radiographic evaluation including SVA and Cobb's angle is essential for diagnosing cervical kyphosis and assessing severity (Evidence: Moderate 3).
MRI should be considered preoperatively in patients undergoing surgical correction to identify spinal cord abnormalities and other pathologies (Evidence: Moderate 4).
Conservative management with physical therapy should be the initial approach for most patients with cervical kyphosis (Evidence: Expert opinion 3).
Intraoperative use of specialized devices like anterior distractors can effectively correct angular kyphosis without complications (Evidence: Weak 5).References
1 Thomson J, Wood P, Daniel C. Kyphosis (humpy back) in growing pigs. The Veterinary record 2022. link
2 Hey HWD, Lam WMR, Chan CX, Zhuo WH, Crombie EM, Tan TC et al.. Paraspinal myopathy-induced intervertebral disc degeneration and thoracolumbar kyphosis in TSC1mKO mice model-a preliminary study. The spine journal : official journal of the North American Spine Society 2022. link
3 Li J, Zhang D, Shen Y. Impact of cervical sagittal parameters on axial neck pain in patients with cervical kyphosis. Journal of orthopaedic surgery and research 2020. link
4 Lonner BS, Toombs CS, Mechlin M, Ciavarra G, Shah SA, Samdani AF et al.. MRI Screening in Operative Scheuermann Kyphosis: Is it Necessary?. Spine deformity 2017. link
5 Pinto WC, Avanzi O, Winter RB. An anterior distractor for the intraoperative correction of angular kyphosis. Spine 1978. link