Kyphoscoliosis

Excerpt

Kyphoscoliosis is defined as a combined abnormal curvature of the spine in both the sagittal (kyphosis typically >50 degrees) and coronal (scoliosis) planes, often accompanied by axial rotation of the spinal column. Adult scoliosis is characterized by a lateral deviation of the spine >10 degrees in the coronal plane, as measured by the Cobb angle. Lateral deviations of <10 degrees can be attributed to postural variation rather than true scoliosis (see Image. Scoliosis of the Spine).

In the sagittal plane, kyphosis and lordosis describe the normal forward and backward curvatures of the spine, respectively. When viewed laterally, a normal lordotic curve is present in the cervical and lumbar regions, ranging from 35 to 80 degrees, while the thoracic spine demonstrates a physiologic kyphotic curve, typically between 30 and 50 degrees. Notably, the degree of thoracic kyphosis increases with age: averaging 20 to 29 degrees in individuals younger than 40, 53 degrees in those aged 60 to 74, and 66 degrees in individuals older than 75.

Although kyphoscoliosis most commonly affects the thoracolumbar region, this abnormal curvature may also occur in the cervicothoracic spine. Scoliosis is classified as mild when the Cobb angle ranges from 10 to 20 degrees, moderate when it ranges from 20 to 40 degrees, and severe when it exceeds 40 degrees. The severity, location, number of vertebrae involved, and the extent of axial rotation all contribute to the clinical significance of the spinal deformity. These factors can influence both energy expenditure and pulmonary function, often resulting in considerable physiological compromise.