Older adults, particularly those with a history of stooped or physically demanding work, are at higher risk for developing LDK.
Lumbar degenerative kyphosis (LDK) is a spinal condition often seen in older people. It’s characterized by an abnormal forward curvature of the lower back due to degenerative changes in the spine’s bones and muscles.
The condition often leads to lower back and leg pain, as well as a noticeable hunched posture.
What causes lumbar degenerative kyphosis
Lumbar degenerative kyphosis happens when the spine wears down with age. This wear and tear affects the discs and joints in the lower back, making them deteriorate. The muscles around the spine also weaken and get fatty.
Several occupational factors can directly contribute to the development and progression of LDK.
These include:
- Repetitive bending and stooping: Jobs or activities that require frequent bending or stooping can place excessive stress on the lumbar spine, leading to accelerated degenerative changes.
- Heavy lifting: Consistently lifting heavy objects, especially without proper body mechanics, can strain the spine and contribute to degeneration of the vertebrae and intervertebral discs.
- Prolonged imbalanced posture: Occupations that involve maintaining a non-ideal posture for extended periods, such as working on the ground in a hunched position, can directly affect the spine’s alignment and contribute to kyphotic changes.
- Manual labor: Engaging in manual labor that places significant physical demands on the lower back can increase the risk of developing LDK due to the repetitive stress and potential for injury to the lumbar spine.
Symptoms of lumbar degenerative kyphosis
The symptoms of lumbar degenerative kyphosis include the following:
- Chronic back pain: persistent pain in the lower back
- Postural changes: noticeable forward bending or hunched posture
- Decreased mobility: difficulty in standing up straight or walking
- Muscle weakness: weakness and atrophy in the back muscles
- Fatigue: increased tiredness due to the extra effort required to maintain an upright position
- Nerve pain: pain or numbness in the legs caused by pinched nerves
Treatment options for lumbar degenerative kyphosis
The first-line treatment for LDK typically includes conservative approaches. These treatments focus on managing symptoms and improving the quality of life without surgery. The primary conservative treatments are:
Surgery is considered for people with severe symptoms like difficulty walking, constant pain, or serious posture problems that don’t get better with other treatments.
Here are the most common types of surgery for LDK :
- Spinal fusion: This procedure joins two or more vertebrae to stabilize the spine and correct any deformity. It stops the painful movement and prevents further progression of kyphosis.
- Osteotomy: This surgery cuts and realigns bones to correct spinal deformities and restore proper alignment.
- Laminectomy: This decompression surgery removes a portion of the vertebra called the lamina to relieve pressure on the spinal cord or nerves, reducing pain and improving mobility.
Research shows that measuring pelvic tilt while lying down (supine pelvic tilt or sPT) before surgery is important. If there’s a big difference between sPT and the pelvic tilt after surgery, it can lead to post-surgical problems.
Properly assessing sPT helps doctors plan the surgery better and reduces the risk of complications.
Complementary therapies
Several complementary therapies can be recommended for managing LDK. These therapies can help alleviate symptoms and improve overall quality of life:
- Chiropractic care: Manual adjustments can improve spinal alignment and reduce pain.
- Acupuncture: Inserting fine needles into specific points on the body can relieve pain and improve function.
- Massage therapy: Therapeutic massage can reduce muscle tension and improve circulation.
- Yoga: Yoga can help by enhancing flexibility , strength, and posture through various poses and breathing techniques.
- Tai chi: Tai chi may improve balance, flexibility, and strength with slow, controlled movements and deep breathing.
- Herbal supplements: Natural supplements may reduce inflammation and support overall health. (Consult a healthcare professional before starting any supplements.)
Are treatments for LDK covered by insurance or Medicare?
Many health insurance plans, including Medicare, cover treatments for LDK if they’re deemed medically necessary. This often includes diagnostic imaging, physical therapy, medications, and surgical procedures.
It’s always a good idea to verify coverage details with the specific insurance provider or Medicare to confirm what is included in your plan.
ICD code for lumbar degenerative kyphosis
In the ICD-10 coding system, lumbar degenerative kyphosis is classified under codes related to spinal deformities and degenerative changes.
- M40.00: kyphosis due to vertebral osteomyelitis (for kyphosis due to infection)
- M40.1: postural kyphosis (for kyphosis due to poor posture rather than degenerative changes)
- M40.8: other specified kyphosis (can be used for other forms of kyphosis not specified elsewhere)
What should you avoid if you have lumbar degenerative kyphosis?
Here are the activities to avoid if you have lumbar degenerative kyphosis:
- heavy lifting
- high impact activities (for example, running and jumping)
- prolonged sitting or standing
- slouched, bent, or hunched posture positions
- incorrect exercises (for example, excessive bending or twisting)
- inadequate footwear
- ignoring pain
Takeaway
Lumbar degenerative kyphosis is a spinal condition in which the lower back curves in an abnormal way due to wear and tear.
Managing LDK involves treatment, physical therapy, and avoiding activities that stress the spine, like heavy lifting and high impact exercises. Early treatment and careful planning for surgery, if needed, can improve results and quality of life.
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