For appointments or confidential discussion call
London Clinic 07776 511824
Norwich Clinic 01603 505063

The London Norwich Spine Clinic is based at
Hospital of St Johns & St Elizabeth, St Johns Wood, London
and the Spire Norwich Hospital, Norwich.

Information for GPs

Your spine is one of the most important and complex parts of your body - keeping it healthy is vital if you want to lead an active and pain free life.


When the top of the back is excessively curved and appears more rounded than usual. While some curvature is normal, generally a curve of more than 40 degrees is considered a sign of kyphosis.


  • Poor posture
  • Degenerative diseases of the spine (such as arthritis or disc degeneration)
  • Fractures caused by osteoporosis
  • Injury (trauma)
  • Genetics
  • Scheuermann disease affects young adults, its aetiology is not know but it can cause uneven growth creating wedging of the vertebra and a rounded/kyphosis of the spine


  • Change in appearance of the upper back to a hunched posture
  • Back pain caused by muscle fatigue
  • Stiffness and tenderness in the spine
  • Breathing difficulties (only in severe cases)


  • Physical examination to assess of posture and contours of the spine
  • An X-ray to confirm the condition and determine the cause
  • A MRI usually confirms the cause.

Read more about the investigations we use to assess spinal problems >

Treatment options


  • Painkillers
  • Physiotherapy - to help strengthen the muscles in the back. If the patient complains of a cosmetic deformity than building up the shoulders and chest with exercise may soften the appearance of the rounded thoracic spine.>


If the curve of the spine is large (more than 70 degrees) and is causing persistent pain with progressive deformity than surgery may be required.

Spinal fusion

Depending on the severity of the curve surgery may be done through an anterior or posterior approach. If the deformity is flexible than the vertebrae are fused together using metal screws and rods. If the deformity is rigid than the spine has to be broken in a controlled manner and than realigned to desired shape.

Depending on the complexity the surgery takes many hours to complete and involves a 5-7 day stay in hospital after the operation.

"The operation has improved my life so much. Thank you." Read case studies >

Case studies

Miss A, aged 16

Condition: Scheuermann's Kyphosis

Treatment: Spinal fusion

Scheuermanns Kyphosis

Mr Rai's notes

"Miss A was referred to me with a painful kyphotic deformity of her thoracic spine that was getting worse with time. All conservative means had failed so the team suggested surgery.

I inserted screws into each vertebra and took out multiple wedges from behind. The deformity then was corrected by linking the screws to some rods to straighten the spine.

The operation took about six hours and we used spinal cord monitoring to ensure the procedure did not cause any damage to the delicate spinal nerves."

Scheuermanns Kyphosis

The patient's experience:

"I was being bullied at school because my shoulders were getting more and more rounded and I looked as if I was leaning forward all the time. I felt shy and found it hard to talk to people.

Since the operation, life is so much better. I look like my friends now and don't stand out. I fit in and I'm not bullied any more. The operation has improved my life so much. Thank you."