Abstract
The kyphosis angle of the thoracic spine tends to increase with aging. Hyperkyphosis is a kyphosis angle, exceeding the normal range. This narrative literature review aims to provide an overview of the current literature concerning kyphosis measurement methods, the etiology and adverse health effects of hyperkyphosis. As of yet, a well-defined threshold for hyperkyphosis is lacking. To attain more generalizability and to be able to compare study results in older adults, we propose to define age-related hyperkyphosis as a Cobb angle of 50° or more in standing position. Hyperkyphosis may be a potentially modifiable risk factor for adverse health outcomes, like fall risk and fractures. Additionally, hyperkyphosis may indicate the presence of osteoporosis, which is treatable. Prospective and intervention studies, using a Cobb angle of 50° as a clear and uniform definition of hyperkyphosis, are warranted to investigate the clinical relevance of hyperkyphosis.
Highlights
Kyphosis is the curvature of the thoracic spine, formed by the shape of the vertebrae and the intervertebral discs and–in standing position–paraspinal muscle strength
This review aims to provide an updated overview of the current studies and to conclude whether hyperkyphosis is relevant for clinical practice
This review reveals several shortcomings in the literature concerning the clinical relevance of hyperkyphosis
Summary
Kyphosis is the curvature of the thoracic spine, formed by the shape of the vertebrae and the intervertebral discs and–in standing position–paraspinal muscle strength. Hyperkyphosis is present when the kyphosis angle exceeds the normal ranges. Apart from the consequences of normal aging, like decreasing muscle strength [1] and degenerative changes of the spine [2], other factors contribute to the increase of the kyphosis angle. Vertebral fractures are present in no less than 40% of the persons with hyperkyphosis [3], and with each vertebral fracture the kyphosis angle increases with 3.8◦ [4]. Numerous kyphosis measurement methods have been used in literature and a clear definition of hyperkyphosis is lacking. We will discuss the etiology and adverse health effects of hyperkyphosis, and will focus on kyphosis measurement methods. Based on the literature described, we will propose to define hyperkyphosis as a Cobb angle of 50◦ or more in standing position
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