Thoracolumbar Kyphosis

What it is

The thoracolumbar junction — where the stiff upper back meets the mobile lower back — is normally close to straight, a transition between the gentle forward curve above and the backward curve below. Thoracolumbar kyphosis is an abnormal forward bend at this junction. It can follow a healed fracture, the wear of aging, Scheuermann’s disease carried up from adolescence, or a previous surgery.

What it feels like

People often describe back fatigue and aching from holding themselves upright, a sense of stooping forward, and in more pronounced cases difficulty standing straight or keeping the trunk balanced over the pelvis. If the curve narrows the canal, leg symptoms can appear.

How we follow it

Standing X-rays measure the curve and your overall balance and show whether it is flexible or rigid. An MRI checks the nerves if you have leg symptoms. How fixed the curve is, and how it affects your balance, guide what comes next.

How we treat it

Flexible, symptom-light kyphosis is managed with physical therapy, posture and core work, and time. When the curve is rigid and genuinely limiting — throwing off your balance or compressing nerves — surgery to realign and stabilize the spine may be considered, which involves a fusion. Because that is a bigger operation, I reserve it for when the deformity is truly driving the problem and aim to correct and fuse only what is necessary.

The science — for the curious

Balance is the theme: the body works hardest when the trunk drifts in front of the pelvis, because every muscle has to fight gravity to keep you upright. That is why treatment targets a balanced, comfortable posture rather than a perfectly straight X-ray, and why — as with any fusion — correcting only what is necessary protects the levels nearby from extra strain.

Learn more

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

OrthoInfo — Osteoporosis and Spinal Fractures: 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.