The necessity to differentiate between thoracic hyperkyphotic curve types based on architecture in order to propose an appropriate treatment strategy

Abstract

Regardless of etiology, a morphologic classification of thoracic hyperkyphosis is needed for health care professionals to treat their patients adequately. Traditionally, thoracic hyperkyphosis has been defined as a kyphosis of more than 50° using the Cobb angle at differing vertebral levels. This radiologic curvature cut-point offers limited understanding of the overall deformity that occurs in the spines of hyperkyphotic patients. For example, hyperkyphosis can be created by different postures in the sagittal plane and can be localized to different regions in the thoracic spine for a given Cobb angle. Recently, ideal geometric, average geometric, and individual optimized geometric sagittal plane curve models for thoracic kyphosis have been presented in the literature. Using these models as a normative starting position of thoracic kyphosis, it may be possible to describe and differentiate types of hyperkyphosis.