Kyphosis is a deformity that produces a hunchback due to the forward curvature of the spine. Some people have postural kyphosis, which is not rigid: others suffer from rigid or structural kyphosis. Existing Scheuermann’s kyphosis (which can exacerbate superimposed compression fractures) is the cause of the deformity. However multiple compression fractures can produce deformity due to collapsed vertebrae, a condition most commonly seen in older women with osteoporosis. SYMPTOMS AND DIAGNOSIS: Low back pain is the most common symptom, but patients may also complain of worsening of the deformity and loss of height; X-rays, MRIs, and CT scans are used to evaluate the deformity. Treatment: Current treatments include physical therapy and nonsteroidal anti-inflammatory drugs. If the patient has osteoporosis, this must also be addressed. As mentioned earlier, there are many effective medications available (e.g., calcitonin) that reduce pain but do not correct wedges or severe spinal deformities. Bracing supports the spine and reduces muscle spasm. If there is any doubt about the underlying cause of a compression fracture, a biopsy may be necessary to rule out tumors, infection, or other conditions. If these conservative measures do not work, surgery may be necessary to control pain and improve deformity or nerve root decompression. In these cases, vertebral kyphoplasty may be most useful, but more extensive fusion with instrumentation may be necessary for therapeutic purposes.