Cervical Kyphosis

What is cervical kyphosis?

When looking at the profile of your body, your neck normally has a natural c-shaped curve. The opening of the C faces your back. This type of curve is called lordosis. In cervical kyphosis, the curve straightens or even reverses, with the C opening toward the front of your body. The curve of your neck determines the level of your natural gaze.

Cervical kyphosis is sometimes called military neck because it causes a straight-necked posture, similar to a soldier. In more severe cases, the curvature in the neck causes a person’s natural gaze to tilt downward.

What is the cervical spine?

Your cervical spine consists of seven bones (vertebrae) in your neck, starting just under your skull. Between each vertebra are discs that cushion the bones so they don’t rub together. A strong network of muscles and ligaments holds the vertebrae in place and gives your neck strength and flexibility.

Your cervical spine supports your head and allows you to move and rotate it. Nerves in your cervical spine branch out to your body, controlling many bodily functions like breathing and upper body movement.

Who is at risk for cervical kyphosis?

Cervical kyphosis is a rare condition that can occur in children and adults.

What causes cervical kyphosis?

Common causes include:

• Ankylosing spondylitis, a disease where vertebrae fuse together.
• Degenerative disc disease, a condition in which the discs between your vertebrae wear down.
• Spinal abnormalities present at birth.
• Spine tumors.
• Trauma or injury of the spine.
• Prior spine surgery

Can surgery cause cervical kyphosis?

Adults and children who undergo a laminectomy can develop cervical kyphosis. Laminectomy is a surgical procedure to ease compression of the spinal cord most often caused by narrowing of the spaces in the spine (spinal stenosis).

With a laminectomy, your surgeon removes a piece of bone (lamina) to relieve pressure. In some cases, the procedure can change the way your head is supported on the cervical spine, leading to a forward tilt. Once this occurs, the weight of your head shifts forward with a resultant progression of the kyphotic deformity.

What are the symptoms of cervical kyphosis?

Cervical kyphosis doesn't always cause symptoms. Some straightening of your cervical spine is normal with age.

When cervical kyphosis causes symptoms, they depend on the severity of the condition. Symptoms are also frequently related to pinched nerves (radiculopathy) or compression of your spinal cord (myelopathy).

Symptoms of cervical kyphosis can include:

• Decreased range of motion of your head and neck, including a permanent downward gaze.
• Difficulty swallowing (dysphagia).
• Headache.
• Instability when walking.
• Loss of fine motor function in your hands.
• Muscle weakness in your shoulders, arms or hands.
• Pain in your neck, back, shoulders or arms.
• Poor urinary (pee) or fecal (poop) control.
• Tingling or numbness in your shoulders, arms or hands.

How is cervical kyphosis diagnosed?

Your provider will ask about your medical history and symptoms and perform a physical exam. The exam will include assessments of your:

• Balance.
• Movement.
• Posture.
• Reflexes.
• Strength.

Medical imaging tests that can help your provider determine if you have cervical kyphosis include:

• CT Scan.
• MRI.
• X-ray.

How is cervical kyphosis treated?

For mild cervical kyphosis, your provider will recommend nonsurgical treatment. For example, medications can help with reducing pain and inflammation.

Physical therapy, such as neck exercises or traction, may provide pain relief and help restore a normal neck curve. However, this type of treatment may not work for everyone.

How is cervical kyphosis treated surgically?

If you're experiencing pain or neurological symptoms, like muscle weakness, tingling or coordination issues, your provider may recommend surgery. The type of surgery will depend on whether your neck has some flexibility or is rigid, such as in ankylosing spondylitis. Surgeons have several techniques to repair the cervical spine, including:

• Posterior approaches, where they enter through the back of your neck.
• Anterior approaches, where they access the spine near your throat.
• Combined anterior and posterior approaches.

Surgeons may cut or remove portions of bones or put in metal plates, rods or screws. Overall, the goals for surgery are to:

• Relieve compression of your spinal cord and nerves.
• Restore the shape of your spine.
• Stabilize your spine.

Will I need follow-up care?

Neck surgery usually requires a hospital stay and a period of rest and limited movement. Your provider will track your recovery closely. Follow your provider’s instructions on what you can do and what you should avoid after surgery. Physical therapy may help you move better with less pain.

How can I prevent cervical kyphosis?

In many cases, you can't prevent cervical kyphosis. If you have a condition like ankylosing spondylitis or degenerative disc disease, talk to your healthcare provider about physical therapy and appropriate exercise. Regular physical activity can reduce pain, increase strength and flexibility, and help prevent further deterioration of your spine. The avoidance of excessively large pillows can minimize flexion when in the supine position (lying on back) during sleep.

What is the prognosis after surgery for cervical kyphosis?

Most surgeries carry a risk of infection, bleeding, blood clots and reaction to anesthesia. Cervical kyphosis surgery poses an additional risk of injury to the spinal cord. Also, because the spine runs the full length of your body from your head to your pelvis, correction of a problem in one part of your spine may lead to problems elsewhere along your spine.

In general, most children and adults do well with surgery. Realignment of your neck and reduction of pain and other symptoms can drastically improve your quality of life.

Is cervical kyphosis reversible?

The forward curve of the spine seen in cervical kyphosis is reversible. Treatment with physical therapy can be effective in mild cases. If you have more severe kyphosis, surgery can correct the curve in your spine and relieve symptoms.

A note from Cleveland Clinic

Cervical kyphosis can cause pain, disability and a decreased quality of life. If you have this condition, talk to your provider about treatment options. Nonsurgical treatments like medication and physical therapy may help. If you have severe symptoms, surgery may be the best choice to correct the shape of your spine. Your provider can help you decide what option is best for you.