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Thread: Can a fractured back cause Kyphosis??

  1. #1
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    Can a fractured back cause Kyphosis??

    Hi all,
    I was wondering if anyone knows if a compression frature can lead to Scoliosis and Kyphosis? My daughter had a compression fracture of T-12 and wore a back brace for 8 months. Prior to this she didn't had any back problems. After the back brace was taken off, her Kyphosis went from 42 to 70 degrees in less then a year. She is now scheduled for surgery.

    Any input on this would be greatly appreciated. Other then this fracture and bracing I don't have a clue what could have caused this.

    Thanks,
    Melanie

  2. #2
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    Melanie,

    Yes, injury and/or trauma could potentially cause either a scoliosis or kyphosis. Inadequate healing of the vertebral body, disc compromise or related soft-tissue and/or visceral lesions could all lead to it (among many others). Your daughter's spine may be collapsing around something of this sort to protect it and limit further aggravation and loss of integrity or function... it's not uncommon although you'd be hard-pressed to hear that from an MD as these sort of things are difficult to quantify with diagnostic or imaging tools.

    Bones mending back together is one part of the healing process, unfortunately it won't necessarily mean that other components have been restored to their proper function that were affected in the accident.

    What has your Doctor suggested as the cause? If you don't mind me asking. Have you tried anything prior to the upcoming surgery?

    Best Regards,
    Structural

  3. #3
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    Hi Melanie...

    If you include fractures from bone loss, it's probably the leading cause of kyphosis.

    Good luck with the surgery.

    Regards,
    Linda

  4. #4
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    Linda,

    Maybe you can answer this for me. Do doctors usually put kids with a compression fracture in a brace because they are still growing? The reason I ask is that my husband had two compression fractures in his back and they really didn't do anything. He was kept off work for a while because his job requires constant lifting, but not much else.

    Thanks,
    Mary Lou
    Mom to Jamie age 21-diagnosed at age 12-spinal fusion 12/7/2004-fused from T3-L2; and Tracy age 19, mild Scoliosis-diagnosed at age 18.

  5. #5
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    Linda,

    From my humble standpoint, bone loss among children is very rare... I don't know anything about Melanie's daughter obviously, but it would seem unlikely that bone loss is the cause in this case. Do you know of the statistics for premature bone loss in children?

    I have noticed quite frequently the occurrence of kyphosis in individuals with compromised cardiopulmonary conditions (either from health related factors or injury/trauma) which preceded the onset of the kyphosis. With the numerous ligamentous and fascial support structures for the heart and lungs attaching to the front of the thoracic spine this type of scenario is quite likely.

    Snoopy,
    If your husband (& the Drs.) felt it was safe to recover without a brace then it is generally for the best. Bone heals much stronger and with greater functional integrity when you allow for functional movement and loading forces to occur during the process (within reason of course). It is these forces that stimulate the growth of new bone/fracture repair at a rate much faster than if it was immobilized and on bed rest for too long.

    This would be of benefit to children as well but they may be more likely to cause more harm if not braced due to the fact that they're children and thus don't have the same degree of care and caution regarding physical activity. I'm sure it's also dependent on the type of fracture - degree, severity, location, etc... extreme growth rates are also a consideration.

    structural

  6. #6
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    Structual,

    Thank you.

    Mary Lou
    Mom to Jamie age 21-diagnosed at age 12-spinal fusion 12/7/2004-fused from T3-L2; and Tracy age 19, mild Scoliosis-diagnosed at age 18.

  7. #7
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    Hi Structural,
    A year ago it was decided that Skylar didn't need her back brace anymore. We were not told of any curvature whatsoever at that point...only to let her live her life. I was initially told that once you have compression fracture that the shape will remain in a V type of shape vs a retangular shape that it should have...that this can not go back to the way it was. I was always very cautious to no refracture this. Skylar was in rehab and was in so much pain that we started further testing with bone scans, density checks, etc...and I was stunned when they told me she had scoliosis but that her kyphosis was extensive. So I'm just trying to make sense of this.

    I don't know if you've read other info regarding my daughter (posted in different sites within this group and not much feedback). Background is... my daughter never had any back issues at all. She did have a brain tumor that was removed and suffered massive stroke in 2004, she spent 5 months in the hospital with extensive PT, OT and speech. She learned how to walk again and was doing great!! But after she broke her back she continued to decline. The brace and all set her way back. When we did find out about the kyphosis, we discussed bracing but it was already too late. They didn't think it would slow the progression down and that she wouldn't be able to tolerate it.

    Skylar has also since developed osteoporsis. She is now on Lovenox (blood thinners) and Estrogen, due to the damage to her pituitary gland from the tumor and rare blood clotting disorder.

    I thank you for all your input!!!

    Melanie

  8. #8
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    Hi MaryLou...

    I know almost nothing about compression fractures. I did find this:

    http://www.umm.edu/spinecenter/educa..._fracture.html

    Structural, you'll notice I neither said nor implied that children suffer from osteoporosis.

    --Linda

  9. #9
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    Thanks Linda. I always appreciate your help.


    Melanie,

    My daughter had surgery over 2 years ago for her Kyphoscoliosis (Kyphosis and Scoliosis). Her Scoliosis before surgery was 46* and her Kyphosis was 71*. Feel free to e-mail me if you need to talk or have specific questions.

    Mary Lou
    Last edited by Snoopy; 04-22-2007 at 08:08 AM.
    Mom to Jamie age 21-diagnosed at age 12-spinal fusion 12/7/2004-fused from T3-L2; and Tracy age 19, mild Scoliosis-diagnosed at age 18.

  10. #10
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    Linda relax... not here to argue or imply anything.. i was just having a discussion, and was asking you a sincere question.

    I'd greatly appreciate it if you could maybe consider my replies in a different tone than you initially suspect.

    thanks

  11. #11
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    Linda,

    I actually think your suspicion of bone loss is possibly a factor for Melanie's daughter as she has been on medication that has caused premature osteoperosis. In and of itself the osteoperosis doesn't cause kyphosis but given the excessive pressure that's placed on the vertabral bodies in the thoracic spine due to its natural kyphotic curve it is more susceptible to further collapse as a result.

    Melanie,
    I found some of your previous posts to get a better understanding of your daughter's situation... There are many variables that may have contributed to the kyphposis and scoliosis alike. The left side paralysis is certainly one. Although again, I don't know the specifics, asymmetric muscular tone from the paralysis could very well cause the scoliosis. Abdominal weakness probably didn't contribute to the kyphosis since high tonus of the anterior abdominal muscles will actually pull the rib cage down in the front creating more of a kyphosis and compression. Weak spinal musculature (on the back/posterior side) from being in the brace and in a wheelchair would however definitely contribute to it.

    Yes, the deformation of the vertebral body won't change significantly... and it can cause a cascade of further flexion of the rest of the thoracic vertebrae if not addressed very specifically through PT/Physio. Back strengthening work in the thoracic region would be imperative here. Remember that sitting for long periods of time is often detrimental to all of us, when you add in the factors that your daughter has experienced it makes it a bit more antagonizing.

    I wish you and your daughter the best... my thoughts go out to you.
    Structural

  12. #12
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    Jan 2007
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    Hi Linda,
    Thank you for that website! It has great info, and not just for compression fractures! I think anyone in this forum would benefit by reading that. So thank you very much!

    Hi Structural,
    Thank you for all of your input! I know this is all complicated. There is so much involved. The brain tumor that my daughter had destroyed her pituitary gland so she needs many medications to replace what hers would've normally produced. Not one person in the Craniopharyngioma group has developed Kyphosis or Scoliosis and they are on many of the same meds and have developed Osteophorosis too. I actually just got off the phone with one of Skylar's PT's that worked with her....and in his opinion he feels the original chain of event...the fracture then bracing, led to the Kyphosis.

    And yes, it is rare for a child to have osteoporosis. Skylar doesn't produce Growth Hormone and this is likely the cause of this for her. She can't tolerate the synthetic version, and now being on blood thinners just adds to this issue. When the initial fracture happened though, she did not have any issues with her bones.

    Thanks to everyone for your comments on this!! I really appreciate it!

    Melanie

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