Patient Testimonials

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Read letters and watch video testimonials to learn more about our patients' experiences with Dr. Antonacci and Dr. Betz.

Testimonials By Condition: Spondylolisthesis, Herniated Disc, Scoliosis Kyphosis, Spinal Stenosis Sciatica, Degenerative Disc Disease.


Kyphosis

Kyphosis, a particular type of spinal disorder, is a curving of the spine that causes a bowing or rounding of the back, which leads to a hunchback or slouching posture. Types of kyphosis (e.g., lordosis), pain management and other treatment for kyphosis may be found below.




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Defining Kyphosis

When looked at from the side (i.e., the sagittal plane), the spine has three main curves:

  • In the neck (the cervical spine), there is an inward/concave curve (lordosis) of 20-40 degrees
  • In the thoracic spine, there is an outward/convex curve (kyphosis or round back) of approximately 20-40 degrees
  • In the low back (the lumbar spine) there is another inward/concave curve (sway back) of approximately 30-50 degrees

Thus the normal spine naturally has curves. However, in some individuals these curves become more or less pronounced. When the curve becomes abnormally convex, particularly in the thoracic spine, the patient is described as having a hyperkyphosis.

Types and Symptoms of Kyphosis

There are several important terms that spine specialists use to distinguish between different types of kyphosis:

  • Postural curve. This type of curve is flexible and is most likely the result of poor posture. A patient can consciously correct the curve.
  • Structural curve. Patients cannot correct this type of curve. The curve often displays a sharp, angular pattern called a Gibbus, which becomes more prominent when the patient bends forwards and is viewed from the side.
  • Secondary kyphosis. Hyperkyphosis is often the result of another problem in the spine (i.e., secondary), such as a fracture in one or more vertebral bodies, or when multiple discs have degenerated and their height has decreased.
  • Primary kyphosis. A primary kyphosis does not result from another problem in the spine. The most common form of primary kyphosis is Scheuermann’s disease. The exact cause of Scheuermann’s is not known, although there does seem to be a pattern of occurrence in families. The disorder is usually first noted in adolescents in the 12-14 age range, although the condition may start earlier in life. The disorder affects females more than males.

Diagnosis of Kyphosis

Most patients visit a doctor with this disorder when they become aware of a convex curve to their back. Some patients may also see a doctor due to back pain, especially those adolescents who have a thoracolumbar kyphosis.

In addition to the convex curve in the thoracic spine, some patients develop what is called a compensatory curve in the lumbar spine. Your doctor will employ several diagnostic methods to accurately diagnose your condition.

A physical exam will help to visually identify a curve. A forward bending test will be used to determine if a thoracolumbar curve exists. In addition, the doctor will look for tightness of the hamstrings and tenderness with some of the spinal muscles, both of which are common symptoms of Scheuermann’s kyphosis.

At least two specific x-rays will be taken. The first is a standing, lateral (sideways) x-ray, and the second is standing x-ray from the front. These are used to identify the curves in the sagittal plane (side view), and to determine if a curve exists in the frontal plane as well. In addition to x-rays, your doctor is likely to order an MRI to provide further imaging detail of the spine.

Particular attention will also be given to the radius of your curve. If the radius is relatively large, it indicates that the curve is smooth. A smaller radius indicates that the curve is sharp and angular. Curves that are more angular are more likely to progress.

Treatment Options for Kyphosis

If thoracic kyphosis in an adolescent exceeds 70 degrees it is a clearly visible deformity. Treatment is usually recommended to prevent further progression of the curve.

Non-Operative Treatment for Kyphosis

The primary non-operative treatment of Scheuermann’s kyphosis is to use a brace to prevent further curve progression. The brace will be carefully fitted by a specialist to ensure maximum comfort, and can be worn under clothes. In addition, your doctor is likely to prescribe a carefully designed exercise and physical therapy program to help spinal flexibility and increased muscle strength.

Surgical Treatment for Kyphosis

If the curve continues to progress after non-operative treatment, or when the kyphosis is severe, surgery may be considered. Candidates for surgery include patients who have:

  • A rigid thoracic curve that is progressing and exceeds 80-90 degrees;
  • A rigid thoracolumbar curve exceeding 60-70 degrees; and/or
  • Disabling back pain

Specialists in Spine Surgery

Get your Case Study Review by Dr. Darryl Antonacci, The Leader In Less Invasive Complex Spine Surgery.


darryl-antonoacci-tnTogether Dr. Antonacci and Dr. Betz have a combined 50+ years of experience in complex spine surgery.

Specialists in Spine Surgery

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M. Darryl Antonacci, MD
Chief Spine Surgeon & Director
Specialist in Pediatric & Adult Spine
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Randal R. Betz, MD
Spine Surgeon
Specialist in Pediatric Spine
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The surgical procedure will be tailored to fit your specific condition. Your surgeon may do the procedure from the front of the spine, from the back of the spine, or may do a combined procedure that involves approaches from both the front and back. A fusion of several vertebrae supported by instrumentation (including hooks, screws and rods) will probably be used to correct the spine’s alignment and to prevent further curve progression.

Recovery from Kyphosis Surgery

Surgery to correct Scheuermann’s kyphosis is a major procedure, requiring a gradual and careful recovery period. Prior to surgery your medical team will explain what to expect in the recovery process. After surgery you will be instructed and encouraged through each stage, from leaving the hospital, to beginning light exercise and returning to school or work.

 

Our Offices Are Conveniently Located in Manhattan and Central New Jersey

Have Your Spine Case Doctor-Reviewed by Nationally Renowned Spine Surgeon, Dr. Darryl Antonacci. After Doctors’s review, a staff member from Dr. Antonacci’s and Dr. Betz’s office will contact you typically within 48 hours for more information about your condition or to schedule an appointment.

Our Office Locations


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Near Princeton, NJ
3100 Princeton Pike,
Bldg. 1-D
Lawrenceville, NJ 08648
Office: 609-912-1500
Fax: 609-912-1600


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Upper East Side, NYC
800A Fifth Avenue,
Suite 301
New York, NY 10065
Office: 609-912-1500
Fax: 609-912-1600


NJ and NY Spine Surgery Treatment Centers


University Medical Center,
Princeton NJ

253 Witherspoon St, Princeton, NJ 08540
Mount Sinai Medical Center,
New York City

1 Gustave L. Levy Pl, New York, NY 10029
Saint Peter’s University Hospital,
New Brunswick, NJ

254 Easton Ave, New Brunswick, NJ 08901
 

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