Mother has had a Dowager's hump since she was 50 years old. Now at 75, she is starting to have tiny fracture lines develop in her spine. Are the two problems connected? Why are these fractures just developing now?

Posted July 30th, 2009 by Matt

Spine Thoracic

The Dowager's hump in medical terms is called hyperkyphosis. It is an increase in the forward curvature of the spine -- usually in the lower cervical (neck) and upper thoracic areas. A visible hump appears along the back of the spine. The head juts forward like a turtle out of the shell and eventually the chin drops down to the chest if the curve is pronounced enough.

There's always been an assumption that having a Dowager's hump increases the risk of vertebral compression fractures. The forward bend of the vertebrae compress the front half of the bone causing a wedge-shaped deformity when viewed from the side on an X-ray. Over time, with age-related degenerative disc disease and osteoporosis developing and/or progressing, vertebral fractures can occur.

But it's no longer so certain that the hyperkyphosis is actually a cause of vertebral compression fractures. Several studies have shown that just as many people with hyperkyphosis don't ever develop vertebral fractures. So is there a link between the two? We don't know yet.

Because this is a fairly common problem about which we don't know much, there's been a call for increased research to identify the underlying causes, ways to treat it, and ways to prevent it.

Hyperkyphosis: A Common, Poorly Understood Condition. In The BACK Letter. July 2009. Vol. 27. No. 7. Pp. 76-77.

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