GIBBUS (KYPHOSIS) SURGERY

GIBBUS (KYPHOSIS) SURGERY

What is a gibbus deformity?

When you look at a normal human side, there are successive reverse curves in the back and the waist. Increased frontward inclination of the dorsal spine is known as gibbus deformity. Gibbus is also known as kyphosis. The gibbus deformity is often caused by an abnormal posture, but it may be seen structurally as well. The gibbus deformity arises due to abnormal posture is called postural kyphosis. Structurally evolving gibbus is called Scheuermann kyphosis. Apart from these, gibbus may also be seen in diseases such as bone erosion, arthritis, fractures of the spine. Head of the patient with the gibbus is forefront when viewed from the side, and when the patient is naked, the gibbus angle can be seen clearly.

Postural Gibbus (Kyphosis)

Today, people spend most of their time during the day at the desk, in front of the computer and in front of the television because of the development of information technologies and they do not live an active life. This lifestyle causes a postural gibbus as people with this lifestyle practice abnormal posture, sitting and lying positions. Heavy backpacks, especially carried in school-age children, can also cause postural gibbus. When the patient corrects the posture, the gibbus disappears. The first step in the treatment of the postural gibbus is to change the abnormal postural habit. Ergonomic and personal arrangement of the positions of tools such as table, chair, and computer in the working environment is important in the treatment of the gibbus. In addition, increasing the hours for exercises to strengthen the muscles holding the spine at a steep position and sports activities is another measure that can prevent the gibbus. When postural gibbus is detected by orthopedics and physical therapists, early precautions must be taken otherwise the spinal muscles may shorten and the gibbus may become permanent.

Scheurmann Kyphosis

The cause of Scheurmann’s disease is usually unknown. In the case of this type of gibbus, it is seen that the front face of the vertebra, which is normally square in the standing lost its heights and can be detected by side x-rays. The angle of gibbus deformity is over 55 degrees. Unlike the gibbus formed due to postural disorder, the gibbus does not improve even if the patient tries to change the posture. In the dorsal region and in the dorsal-to-lumbar junction, there are two possible areas of gibbus. In addition to the gibbus, dorsal and lumbar pain may accompany the illness. Treatment is more difficult than the gibbus due to postural disorder. Scheurmann’s disease-related gibbus should be taken early if detected by the orthopedics and physical therapists. In Scheurmann patients with tractable to moderate gibbus corset therapy may stop the progression of the gibbus. Corset needs to be worn for at least 20 hours a day. Surgery is necessary in patients with advanced gibbus.

Other causes of gibbus

Gibbus may also develop with the cases like calcification of dorsal spine, some rheumatic diseases, injury to the spine due to trauma, some bone diseases, spine infection, and bone erosion. The most common cause of humpback in elderly patients is bone disease.

Surgery for Gibbus Deformity

Surgical treatment is required over 75 degrees in the angle of the gibbus due to the structurally developing Scheurmann’s disease. Curvature is corrected in the surgery to prevent progression. The most commonly used method for this type of operations is “posterior fusion surgery”. Corrective surgery, known as “osteotomy” which is performed by removing a fragment from the spinal column, is a choice for much more advanced gibbus patients. After surgery, patients can stand up after 1 day and can be discharged after about 1 week. It is recommended to use a corset for approximately 3 months. Light sporting activities in the 3rd month after the surgery and activities such as football, basketball, etc., which require contact in the first year can be allowed.