Thoracic spine kyphosis

The spinal cord emerges from the brain stem at the base of the skull and terminates at the second lumbar vertebra. The thoracic spine is most vulnerable to cord compression because of natural kyphosis and because the width of the thoracic spinal canal is the smallest among the vertebrae. Most spinal cord compression is due to adjacent vertebral metastases that compress the spinal cord or from pathologic compression fracture of the vertebra. This results in significant edema and inflammation in the affected area. 

There was kyphosis of the thoracic spine from T7 to T9, with pathological fractures. An MRI scan showed massive epidural fat extending from T1 to T9. She recovered 3 months after surgical removal of the epidural fat. 

Observation of the thoracic spine shouid be performed from the back and from each side. One should observe for any abnormal curvature of the spinal column. Kyphosis, an increase in the normal anteroposterior curvature of the spine, or scoliosis, an abnormal lateral curve should be looked for. Kyphosis is sometimes manifested in the upper thoracic spine as the dowager s hump so frequently seen in osteoporosis, especially in older women. Flattening of the thoracic spine may be seen in the presence of muscle spasm or somatic dysfunction. See Chapters 48, 58, and 78 for a further discussion of these postural changes and their significance. 

Kyphosis is an abnormal forward bending ofthe thoracic spine. It can be postural or structural. 

Kyphosis is a curvature of the spine in the sagittal plane with the convexity posteriorly. A moderate degree is normal in the thoracic spine. However, an exaggeration of the curve is abnormal. Poor posture with weakened musculature is the most common cause. In this case, the shoulders slouch forward, the head drops down and forward, and the thoracic spinal curve is increased. The abdomen tends to protrude. Habit and occupation are the main offenders. 

Flattening of the lumbar lordosis is often caused by muscle spasm and may be a part of a herniated disc syndrome. The flattening associated with a herniated disc generally is seen with a listing of the patient away from the side toward which the disc has herniated. The flattening may also be compensatory to flattening of the kyphosis in the thoracic spine. 

Parkinson s patients begin to adopt a flexed posture, with the head tilted forward and an increased kyphosis of the thoracic spine. The gait is slow and shuffling. Flexion of hips, knees, and ankles is decreased, so tripping and falling occurs frequently causing multiple injuries. Occasionally an extension of the head and neck occurs, making it difficult for the individual to see... 

The understanding of the relationship static spine - position of the pelvic/ sacrum and position of the femoral heads - can best be derived from a Bech-terew kyphosis - pre- and postoperatively. In addition to the flattened lumbar lordosis and thoracic kyphosis, the preoperative picture shows clear retrover-... 

Through formation of lumbar hyperlordosis and flattening of thoracic kyphosis, the slipping process can be compensated up to a certain point, i.e., the position of the gravity line will, as described above, move around the center of the femoral heads. However, if a critical value is exceeded during the slipping process, there are two basic possibilities as to how the spine behaves towards the center of the femoral head ... 

Fixator for the fixation of lower thoracic and lumbar spine fractures. The idea of external reduction for spondyloptosis was introduced by Aebi et al. [2] in four patients. In one patient this technique did not allow slip reduction and the lumbosacral kyphosis could be corrected minimally. They suggested that the External Fixator seemed to be a powerful tool allowing gradual reduction of the slip and correction of the lumbosacral kyphosis by distraction (1 mm/day). 

In addition, postural abnormalities are observed resulting from spondylitis deformans of the thoracic or cervical spine, with kyphosis and kyphoscoliosis. Other patients exhibit pes cavus deformities, hallux valgus, or hammer toes. 

The thoracic kyphosis may increase as a compensation for increased lordosis in the cervical or lumbar spine. Kyphosis is often associated with a structural scoliosis, Ityphoscoliosis... 

An increase in the iordosis of the cervicai spine is most often caused by posturai changes with the head carried forward of the iine of gravity through the body. The head iiits back to keep the eyes ievei, thus increasing the cervicai iordosis. Cervicai iordosis may occur as the resuit of compensation for an increase in the thoracic kyphosis. 

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