Cervicothoracic Kyphosis

What it is

Cervicothoracic kyphosis is an abnormal forward bend at the junction where the neck meets the upper back. This junction carries the weight of the head over the chest, so a forward tip here can be hard for the muscles to compensate for. It can follow degenerative wear, a previous neck surgery, an injury, or a longstanding deformity.

What it feels like

Common complaints are neck and upper-back fatigue from holding the head up, a chin-forward posture, and in more pronounced cases difficulty looking straight ahead (keeping a level gaze). If the curve stretches or crowds the spinal cord, the warning signs of cord involvement — hand clumsiness, balance trouble — can appear.

How we follow it

Standing X-rays measure the curve, your horizontal gaze, and how your head balances over your trunk, and they show whether the curve is flexible or fixed. An MRI checks the spinal cord. Rigidity, balance, and the cord guide the plan.

How we treat it

Flexible, mild cases are managed with physical therapy and posture work. When the curve is fixed and significantly affecting your gaze, comfort, or the cord, surgery to realign and stabilize the junction may be considered, which involves a fusion. This is a bigger operation at a demanding part of the spine, so I reserve it for genuine, limiting deformity and correct only what is necessary.

The science — for the curious

Keeping a level gaze and the head balanced over the body is one of the most important jobs of spinal alignment, and the cervicothoracic junction is where that balance is set. Correcting a fixed kyphosis here is about restoring that balance and protecting the cord, not about appearance alone — and as with any fusion, doing the least that achieves a balanced, stable result protects the levels nearby.

Learn more

Scoliosis Research Society — Scheuermann’s Kyphosis: srs.org

OrthoInfo — Neck Pain: orthoinfo.aaos.org

This handout is general education about a common condition and does not replace the personalized advice we discuss in clinic. If anything here does not match what we talked about, what we talked about wins — please ask me.