ABSTRACT
Background: Thoracic hyper-kyphosis is a postural deviation that is associated with morbidity and mortality. There is limited evidence for the non-surgical reduction treatment for this condition. Objective: To describe the successful case of conservative reduction in thoracic hyper-kyphosis utilizing thoracic extension traction methods as performed in Chiropractic BioPhysics (CBP®) Technique. Clinical Features: On May 8, 2009 a 24-year old female music teacher reported to a spine clinic in Las Vegas seeking treatment while suffering from neck, mid, and low back pain as well as headaches. The major postural condition was determined to be a hyper-kyphotic thoracic spine with concomitant posterior thoracic translation. Intervention and Outcome: This patient was treated with full CBP® protocol with the unique application of thoracic extension traction. Although the treatment was interrupted by her involvement in a motor vehicle collision, a clinically significant reduction in her kyphosis occurred bringing her spine to within normal limits. She had simultaneous improvements in her clinical symptoms, neurologic and orthopedic tests. Discussion: Traditional conservative treatment options for thoracic hyper-kyphosis have included exercise, manual therapy, spinal orthosis, ‘practiced normal posture,’ and more recently, taping. All of these procedures, however, have been criticized because despite these methods as showing promise for improving health outcomes in patients with hyper-kyphosis, the trials used to evaluate them have been “small in scale, and most short in duration.” Since this deformity is associated with osteoporosis and worsening of kyphosis it is well advised to treat this condition earlier rather than later. Conclusion: Although traditional approaches to non-surgical treatment for thoracic hyper-kyphosis has weak supportive evidence, we propose extension traction for this condition will prove to be an effective treatment option.