Kyphoscoliosis Spine

Kyphoscoliosis – Causes, Symptoms and Treatment

Table of Content

  1. What Is Kyphoscoliosis?
  2. Kyphoscoliosis ICD 10
  3. What Are The Causes Of Kyphoscoliosis?
  4. Kyphoscoliosis Symptoms
  5. What Are The Risk Factors Of Kyphoscoliosis?
  6. How Is Kyphoscoliosis Patient Diagnosed?
  7. What are the treatments available for Kyphoscoliosis?

What Is Kyphoscoliosis?

Kyphoscoliosis is a spinal deformity characterized by abnormal curves of the spine in two planes. Kyphoscoliosis may occur at any age group, but more common in children, below the age of 16 years that is before the puberty. In the majority of the patients, the mobility of the vertebrae is decreased significantly interfering the active strengthening of the spine. Let’s explore more details about the causes, symptoms, and diagnosis and treatment options of Kyphoscoliosis.

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Let’s Look Into More Details about Kyphoscoliosis

Mostly, the Kyphoscoliosis cases are mild, but some children develop spinal deformities that become more severe as they grow. A severe spinal curve can decrease the amount of space within the chest, making it difficult for the lungs to function properly, and also cause disability of the patient. A Kyphoscoliosis spine looks like the letter ‘C’ or ‘S,’ when it is viewed from the front or back; whereas, normal spine looks straight from the same view.

The children with mild Kyphoscoliosis are monitored by taking X-rays to see if the curve is getting worse. Usually, the patients with mild Kyphoscoliosis do not need any treatment. However, in some cases, the doctors may advise wearing a brace to prevent the curve from getting worse, whereas, some cases with severe deformity needs surgery to straighten the spine.

Kyphoscoliosis ICD 10

ICD 10 is the medical classification list by WHO (World Health Organization) which contains codes for injury or diseases in relation to –

  • Diseases
  • Signs and Symptoms
  • Abnormal Findings
  • Complaints
  • Social Circumstances
  • External Causes

ICD 10 code for Kyphoscoliosis of thoracic spine is ICD-10-M40.04

Read More: ICD 10 code for Kyphoscoliosis

What Are The Causes Of Kyphoscoliosis?

Some of the possible causes of Kyphoscoliosis are:

Idiopathic:

This type of scoliosis is commonly seen in 80% of the cases without any specific cause.

Defect from Birth:

This kind of scoliosis is rare and occurs due to the congenital (from birth) deformity of the spine.

Neuromuscular Issue:

20% of the cases are caused by neuromuscular type conditions such as cerebral palsy (CP) or muscular dystrophy.

Length of the Leg:

If the length both the legs is not symmetrical, it can lead to Kyphoscoliosis.

Heredity:

Kyphoscoliosis may occur due to the involvement of the gene – GPR126.

Other Causes of Kyphoscoliosis:

Poor posture, carrying heavy weights, and doing wrong exercise, can also cause Kyphoscoliosis.

Kyphoscoliosis Symptoms

How would you know that your child has Kyphoscoliosis? Well, if your child has the following symptoms, then visit your doctor:

Signs of Kyphoscoliosis

  • Uneven shoulders
  • Uneven waist
  • Shoulder blade on one side may be more protruding compared to the other one
  • A hip higher than the other

If the curve worsens, it will also make the spine rotate or twist, which may impact on the ribs on one side, protruding it forward more than the other side. As a result, the patient has pain and difficulty in breathing.

What Are The Risk Factors Of Kyphoscoliosis?

Risk factors for developing the most common type of Kyphoscoliosis include:

Age:

Signs and symptoms scoliosis usually begin to occur during the growing stage of the children, just before the puberty, between the ages of 9 to 15 years.

Gender:

Girl Childs has a much higher risk of worsening curve and requires treatment.

Family History (Hereditary):

Kyphoscoliosis can be hereditary, but most children with scoliosis have no family history of the disease.

How Is Kyphoscoliosis Patient Diagnosed?

First of all, the physician will take the detailed medical history, and may ask some related questions about the recent growth of the child to her/his parents. During the physical examination, the doctor may ask your child to stand and then bend forward from the waist, hanging the arms freely, to see if one side of the chest is more prominent than the other.

Your spine specialist may also perform a neurological examination to check the following things:

  • Muscle weakness
  • Numbness
  • Abnormal reflexes

Kyphoscoliosis Radiology:

A plain radiograph can help confirm the diagnosis of scoliosis and reveal the severity of the curvature of the spine. Your doctor may suggest taking some e Kyphoscoliosis radiology tests if any tumors or any other issues are suspected to be the cause of the condition.

  1. MRI (Magnetic Resonance Imaging): MRI uses powerful magnetic field and radio waves to produce detailed images of bones and soft tissues.
  2. CT (Computed Tomography): CT combined X-rays taken from many different directions to produce images with more details than the plain radiograph does.
  3. Bone scan: Bone scans involve injecting a radioactive material that travels to the parts of the bones that are injured or in the healing process.

As mentioned above, many children with scoliosis have smooth curves and probably may not need the treatment with a brace or surgery. Children who have mild Kyphoscoliosis may require examinations in every 4 to 6 months of intervals, to observe if there are any changes in the curvature of the spine.

What are the treatments available for Kyphoscoliosis?

The treatments of Kyphoscoliosis mainly depend on the following factors:

  • The maturity level of the skeleton of the patient
  • The intensity of spinal curvature.

A small degree of spine curvature in a patient, who is still in the growing phase, does not require treatment; but the young Child with a significant curve usually continues to worsen, so it needs a proper treatment. There are three treatment options available for the scoliosis patients, such as;

  • Observation
  • Braces
  • Surgery 
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Observation:

After your child is diagnosed with scoliosis, the doctor will keep the child in the observation period. He/she will check the curve on a regular basis, after every 4-5 months, to check if there is any change of the spinal curve. Depending on the rate of changes, your doctor will decide the next step of the treatment.

Braces for Kyphoscoliosis:

Poor posture is increasingly become an issue in our day-to-day world, where office workers need to sit for extended periods of time in front of the computer, with few breaks. When you sit slouched at a desk for hours it can have debilitative effects on the muscles in our backs, requiring the use of a Milwaukee brace.

General Usage of Milwaukee Brace

Nowadays, this is used as a type of body brace that supports your back. The spinal curvatures of children with scoliosis (abnormal curvature of the spine), or kyphosis (extended outward curvature of the spine, or hunchback) was corrected by using Milwaukee Brace in the past.

They are also known as cervico-thoraco-lumbo-sacral orthosis or CTLSO. They used to be used to only straighten children’s backs, but special braces have been designed for adults to wear as well, in order to correct bad posture.

To achieve correct posture, a Milwaukee brace is the best way to achieve straighter alignment by using this brace you can able to make your back to sit up straighter, especially when working all day on the computer, you’ll find that you not only experience less back pain, but that people will notice you looking more confident as well. With proper advise from your doctor, the brace can be worn for 23 hours per day to minimize the risk of curve progression.

If the child is in a growing phase and having moderate scoliosis, your physician may suggest using a brace. Using a brace will not reverse the condition, but it will help stop the progression of the spinal curve. Usually, the braces are used day and night. The result of using a brace depends on the number of hours the patients wear it. The parents should always take care in following the instructions given by the doctor while using the braces because there is few restrictions on wearing a brace.

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Kyphoscoliosis Surgery:

Scoliosis progresses gradually with age. The doctor may suggest for the Kyphoscoliosis surgery based on the severity to minimize the spinal curve and prevent further worsening of the condition. The most common surgery performed for the scoliosis is spinal fusion. The surgery is usually done after the child’s bone stops growing. If Kyphoscoliosis is progressing rapidly at the early age, surgeons can install a bar in between the spine bones to adjust the length as the child grows. Complications of spinal surgery can include bleeding, infection, and pain and nerve injuries. In rare cases, the bone does not heal. In that case, further surgery may be required.

Read More: Are you aware of the postoperative complications of the spine surgery?

Physiotherapy Management for Kyphoscoliosis:

Physiotherapy can be done where the spinal curvature of Kyphoscoliosis is mild, i.e. if it is less than 50 degrees of kyphosis and if it is less than 30 degrees of scoliosis with the underlying cause of bad posture. In such cases, physiotherapy is beneficial and is the first line of treatment for Kyphoscoliosis. The aim of physiotherapy is strengthening the spinal muscles to correct the abnormal curvature of the spine as much as possible and also to prevent further spinal complications.

References:

  1. https://en.wikipedia.org/wiki/Kyphoscoliosis
  2. https://www.cms.gov/Medicare/Coding/ICD10/2020-ICD-10-CM

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