Kyphosis is an abnormal forward curvature of the spine that causes a visible rounding or hunching of the upper back. It ranges from mild postural curves that respond to physical therapy, to severe structural deformities caused by vertebral compression fractures, Scheuermann's disease, or progressive degenerative changes that require surgical correction.
What are the symptoms?
- Visible rounding or hunching of the upper back (thoracic kyphosis) or forward lean of the entire trunk (global sagittal imbalance)
- Back pain and muscle fatigue — particularly with prolonged standing or walking
- Difficulty standing upright or looking straight ahead without significant effort
- Progressive loss of height over months to years
- Shortness of breath or reduced exercise tolerance in severe thoracic curves that restrict chest expansion
- Leg pain, numbness, or weakness if the deformity causes spinal cord or nerve root compression
What causes it?
- Degenerative kyphosis: The most common cause in adults — disc collapse, vertebral compression fractures from osteoporosis, and facet arthrosis lead to progressive forward lean as the spine loses its natural lumbar lordosis
- Scheuermann's kyphosis: A developmental condition in adolescents caused by abnormal growth of the vertebral endplates, leading to wedge-shaped vertebrae and a structural thoracic or thoracolumbar curve
- Osteoporotic vertebral compression fractures: Multiple fractures of the vertebral bodies cause progressive kyphotic collapse, particularly in the thoracolumbar junction
- Iatrogenic: Flat back syndrome following prior lumbar fusion that eliminates lumbar lordosis and shifts the body's center of gravity forward
- Neuromuscular conditions: Weakness of the postural muscles from neuromuscular disease allows the spine to progressively kyphose
How is it diagnosed?
Full-length standing X-rays (EOS or 36-inch scoliosis series) are essential for measuring the degree of kyphosis and assessing overall sagittal alignment — the relationship between the head, pelvis, and feet. MRI provides detail on disc, cord, and nerve root involvement. CT is used for surgical planning. Bone density testing (DEXA scan) is important when osteoporotic fractures are suspected.
Your Non-Surgical Roadmap — Surgery Is the Last Step
Most patients with this condition get better without surgery. Here's the path Dr. Chavarria follows before an operation is ever on the table:
- 1
Start conservative
Physical therapy, activity changes, anti-inflammatory or nerve medication, and time — the first line for nearly every spine condition.
- 2
Add targeted relief
If symptoms persist, image-guided injections (epidural or nerve blocks) can calm inflammation and pinpoint the source of pain — often avoiding surgery entirely.
- 3
Re-evaluate together
Dr. Chavarria reviews your progress and imaging with you, honestly, and explains exactly where you stand — no pressure, no rush to the OR.
- 4
Surgery — only if it's truly the best option
Reserved for severe or worsening nerve compression, instability, or when conservative care has had a fair chance. When it is right, you'll understand why and what to expect.
Treatment Options in Reno, NV — Conservative Care First
Mild to moderate kyphosis is treated with physical therapy emphasizing thoracic extension exercises, core strengthening, and postural correction. Bracing may be used in adolescents with Scheuermann's kyphosis during growth. Osteoporotic compression fractures causing kyphotic pain are effectively treated with kyphoplasty — a minimally invasive cement augmentation that stabilizes the fracture and can restore vertebral height. When kyphosis is severe, progressive, or causing neurological compromise, Dr. Chavarria performs surgical correction using a combination of posterior spinal fusion with instrumentation and, when needed, anterior column reconstruction or osteotomies to restore the natural spinal contour.
Treatment Procedures
Kyphoplasty
Kyphoplasty is a minimally invasive procedure that treats painful vertebral compression fractures — most commonly caused by osteoporosis — by inserting a balloon into the collapsed vertebra, inflating it to restore height, and filling the cavity with bone cement. Most patients experience dramatic pain relief within 24–48 hours and go home the same or next day.
Learn More →Adult Deformity & Scoliosis Correction
Adult spinal deformity — including scoliosis, kyphosis, and flatback syndrome — can cause progressively worsening back pain, leg pain, and difficulty standing upright. Surgical correction realigns the spine, restores sagittal balance, and often dramatically improves the ability to walk, stand, and perform daily activities.
Learn More →Lumbar Spinal Fusion (TLIF/PLIF)
Lumbar spinal fusion permanently connects two or more vertebrae together, eliminating painful motion at an unstable or severely degenerated spinal segment. Techniques such as TLIF (Transforaminal Lumbar Interbody Fusion) and PLIF (Posterior Lumbar Interbody Fusion) restore disc height, decompress the nerve, and stabilize the spine — and can be performed with minimally invasive techniques through small incisions.
Learn More →Lateral Approaches (XLIF / LLIF)
Lateral lumbar interbody fusion — performed through the patient's side rather than the back or front — allows Dr. Chavarria to place a large interbody cage between the vertebrae through a very small incision, with minimal blood loss and no disruption to the back muscles. XLIF and LLIF are powerful tools for treating multi-level disc disease, flatback deformity, and degenerative scoliosis.
Learn More →