Kyphosis Surgery in New York City

Dr. Zeeshan Sardar, MD, MSc, F.R.C.S.C
Director Quality & Patient Safety (QPS) – Och Spine Hospital
Medical Director, Spine Unit – Och Spine Hospital
Co-Chief of Spinal Deformity Surgery • NewYork-Presbyterian / Columbia University
Och Spine Hospital • New York, NY

Kyphosis — an excessive forward rounding of the spine — ranges from a postural condition requiring no treatment to a severe, rigid structural deformity that causes pain, neurological compromise, and profound difficulty standing upright. When kyphosis reaches the point where quality of life is significantly impacted and non-surgical treatment has failed, surgical correction can restore alignment, relieve symptoms, and give patients their function back.

Dr. Sardar specializes in the full spectrum of kyphosis surgery, from Scheuermann’s disease in adolescents and young adults to severe postoperative kyphosis requiring complex reconstruction. He performs the most advanced osteotomy procedures available and has the technical training to manage even the most challenging cases.

WHAT IS KYPHOSIS?

The spine has natural curves when viewed from the side. The thoracic spine (mid-back) curves gently forward, which is normal — typically between 20 and 45 degrees. When this forward curve exceeds 50 degrees, it is considered kyphosis. As the curve increases, patients develop a visible hump or roundback appearance, progressively lose the ability to stand straight, and may experience pain, fatigue, and eventually neurological symptoms if the deformity compresses the spinal cord.

Kyphosis is not a single condition — it is a deformity that can arise from several different causes, each with different treatment implications.

TYPES OF KYPHOSIS DR. SARDAR TREATS

Scheuermann’s Kyphosis

Scheuermann’s disease is the most common structural cause of kyphosis in adolescents and young adults. It occurs when the front edges of multiple vertebrae grow less than the back edges during development, causing the vertebrae to become wedge-shaped and the spine to curve forward. Unlike postural kyphosis, Scheuermann’s kyphosis is a fixed, structural deformity that does not correct with postural changes. Curves typically measure between 45 and 75 degrees, though severe cases can exceed 90 degrees.

Surgery is considered for Scheuermann’s kyphosis when the curve exceeds approximately 70–75 degrees, causes significant pain or neurological symptoms, or has failed bracing treatment in a skeletally immature patient. Surgical correction typically involves posterior spinal fusion with instrumentation, and may include osteotomies to achieve adequate correction in rigid deformities.

Postoperative Kyphosis

Some patients develop kyphosis as a complication of prior spine surgery. This can occur after laminectomy (removal of posterior spinal elements), inadequate fusion, adjacent segment failure above a prior fusion, or as a late consequence of Harrington rod instrumentation. Postoperative kyphosis may be progressive and disabling. Surgical correction — typically involving osteotomy and reconstruction — is often the only definitive treatment.

Degenerative Kyphosis

As the spine ages, degenerative disc disease, compression fractures, and loss of muscle support can cause the spine to progressively round forward. This is particularly common in patients with osteoporosis, in whom vertebral compression fractures can produce sudden, significant increases in forward curvature. Degenerative kyphosis may present with back pain, difficulty standing upright, and in severe cases, neurological symptoms from cord or nerve compression.

Congenital Kyphosis

Congenital kyphosis results from abnormal vertebral development before birth. Some forms are stable and require only monitoring; others are progressive and carry a significant risk of spinal cord compression. Early surgical intervention is often recommended for progressive congenital kyphosis to prevent neurological injury.

Post-Traumatic Kyphosis

Vertebral fractures — whether from trauma, osteoporosis, or pathological causes — can result in kyphotic deformity at the fracture site. When the resulting deformity causes pain, instability, or neurological compromise, surgical correction and stabilization may be indicated.

SIGNS & SYMPTOMS

The presentation of kyphosis depends on the severity and underlying cause. Common symptoms include:

A visible hump or roundback appearance, most noticeable when bending forward
Progressive difficulty standing upright or looking straight ahead while walking
Upper or mid-back pain, often worse with prolonged standing or activity
Fatigue — the muscular effort required to compensate for the deformity is exhausting
Chest tightness or reduced exercise tolerance in severe cases (from reduced chest cavity volume)
Leg pain, numbness, or weakness if the deformity causes spinal cord or nerve compression
In the most severe cases: difficulty walking, bowel or bladder changes, or myelopathy

Not all kyphosis requires surgery. But if your symptoms are progressive, significantly limiting your daily activities, or associated with neurological changes, a specialist evaluation is always the right next step.

DIAGNOSIS & EVALUATION

Every patient presenting with kyphosis receives a thorough evaluation with Dr. Sardar. This includes:

Full-length standing X-rays — 36-inch scoliosis films that allow measurement of the kyphosis angle, sagittal balance, lumbar lordosis, and pelvic parameters
Flexibility assessment — hyperextension X-rays or bending films to determine how much of the curve is flexible versus rigid, which directly informs surgical planning
MRI — to evaluate spinal cord and nerve compression, disc degeneration, and the condition of the posterior elements
CT scan — in revision or complex cases, to assess bone quality, fusion integrity, and bony anatomy
Bone density testing — particularly important in older patients, where osteoporosis significantly affects both surgical risk and implant selection

Dr. Sardar will review all findings with you in detail and explain exactly what the imaging shows, what it means for your symptoms, and what your options are. He will not recommend surgery unless it is genuinely the best path forward for your specific situation.

NON-SURGICAL TREATMENT

Many patients with kyphosis do not require surgery. Non-surgical options are always considered first and include:

Physical therapy — strengthening of the core and posterior musculature can reduce pain and improve posture, particularly in flexible deformities
Bracing — most effective in skeletally immature patients with Scheuermann’s kyphosis to slow or halt progression during the growing years
Pain management — anti-inflammatory medications, activity modification, and interventional pain procedures can help manage symptoms in patients who are not surgical candidates or who prefer to defer surgery
Osteoporosis treatment — in patients with compression fractures and osteoporosis, bone strengthening medications and vertebral augmentation procedures (kyphoplasty or vertebroplasty) may be appropriate for acute fracture management

The decision to proceed with surgery is made together with the patient, based on curve severity, symptom burden, rate of progression, and overall health. It is never made lightly.

SURGICAL TREATMENT

Kyphosis surgery is technically demanding and requires a surgeon with specific expertise in deformity correction and osteotomy techniques. The goals of surgery are to correct the deformity, restore sagittal balance, decompress any affected neural structures, and achieve a solid, durable fusion.

Posterior Spinal Fusion with Instrumentation

For flexible kyphosis — deformities that partially correct on extension — posterior spinal fusion using pedicle screws and rods is often sufficient to achieve correction and stabilization. The instrumentation holds the spine in a corrected position while the bone fuses. This approach is most commonly used for moderate Scheuermann’s kyphosis.

Osteotomy for Rigid Kyphosis

When kyphosis is rigid — as is typical in severe Scheuermann’s, postoperative kyphosis, or long-standing deformity — instrumentation alone cannot achieve adequate correction. An osteotomy is required: a controlled cut through the bone that allows the spine to be repositioned into a better alignment. Dr. Sardar performs the full range of osteotomy techniques:

Smith-Petersen Osteotomy (SPO) — removal of a posterior wedge of bone that allows gradual correction through multiple levels; typically achieves 10–15 degrees per level
Pedicle Subtraction Osteotomy (PSO) — a three-column osteotomy that removes a wedge of bone from the posterior and middle columns of the spine, achieving 30–40 degrees of correction at a single level; the workhorse procedure for rigid sagittal deformity
Vertebral Column Resection (VCR) — complete removal of one or more vertebral bodies; reserved for the most severe, rigid, or angular deformities; among the most technically demanding procedures in all of spine surgery

Combined Anterior-Posterior Surgery

In some patients — particularly those with very rigid kyphosis or those requiring anterior column support for fusion — surgery is performed through both the front and back of the spine. The anterior approach allows release of the anterior longitudinal ligament and disc spaces, which significantly improves the flexibility of the deformity and the degree of correction achievable. This staged or combined approach is planned on a case-by-case basis.

WHAT TO EXPECT: SURGERY & RECOVERY

Recovery from kyphosis surgery depends on the extent of the procedure. Most patients experience meaningful improvement in posture and pain within the first few months, with continued gains as the fusion matures.

Hospital stay: Typically 3–6 days, depending on complexity. Most patients are mobilized the day after surgery.
Return to light activity: 4–8 weeks for most daily tasks.
Return to work: Variable, depending on the nature of the work; sedentary roles often within 6–8 weeks, physical roles 3–6 months.
Full fusion maturation: 12–18 months, during which the bone solidifies and maximum functional gains are realized.
Pre-operative optimization: Bone density, nutrition, and medical comorbidities are reviewed and addressed before surgery whenever possible to reduce risk and improve outcomes.

Dr. Sardar uses robotic-assisted navigation, intraoperative neuromonitoring, and real-time 3D imaging as standard in all kyphosis correction procedures. He personally follows every patient from the pre-operative visit through all post-operative appointments.

FREQUENTLY ASKED QUESTIONS

Is my kyphosis bad enough to need surgery?

Most patients with kyphosis do not need surgery. Surgery is generally considered when the curve is severe (typically over 70–75 degrees for Scheuermann’s), causing significant symptoms that have not responded to conservative treatment, or when there is neurological involvement. A thorough evaluation is the only way to know for certain where your curve stands and what the right approach is for you.

Will kyphosis get worse over time without surgery?

It depends on the type and severity of kyphosis. Scheuermann’s kyphosis tends to stabilize once skeletal maturity is reached in most patients, though severe curves may continue to slowly worsen in adulthood. Degenerative kyphosis associated with osteoporosis can progress significantly, particularly if additional compression fractures occur. Postoperative kyphosis is often progressive if the underlying structural problem is not addressed. Dr. Sardar will discuss the natural history of your specific situation at your consultation.

What is the difference between kyphosis and scoliosis?

Scoliosis is an abnormal side-to-side (coronal plane) curvature of the spine. Kyphosis is an abnormal front-to-back (sagittal plane) curvature, specifically an excessive forward rounding. The two conditions can coexist — a patient can have both scoliosis and kyphosis simultaneously — and both fall within the broader category of spinal deformity that Dr. Sardar specializes in treating.

Can kyphosis cause paralysis?

In severe or rapidly progressive kyphosis, the forward angulation of the spine can compress the spinal cord — a condition called myelopathy. Symptoms of cord compression include leg weakness, difficulty walking, changes in balance, and bowel or bladder dysfunction. Severe myelopathy is a surgical emergency. If you are experiencing these symptoms, seek evaluation promptly.

How much correction can surgery achieve?

The degree of correction depends on the flexibility of the curve, the technique used, and the number of levels addressed. Flexible curves can often be corrected substantially with instrumentation alone. Rigid curves requiring osteotomy can typically be corrected to a more normal range, with PSO achieving 30–40 degrees of correction at a single level. The goal is not always perfect correction — it is a well-balanced spine with the best achievable alignment that can be maintained safely for the long term.

WHY CHOOSE DR. SARDAR FOR KYPHOSIS SURGERY

Kyphosis correction — particularly for rigid or severe deformities — is among the most technically demanding procedures in spine surgery. It requires a surgeon who performs these operations regularly, who has expertise in the full range of osteotomy techniques, and who has the judgment to match the right procedure to each patient’s anatomy and goals.

Dr. Sardar completed his advanced spinal deformity fellowship at Columbia University and NewYork-Presbyterian, one of the highest-volume spinal deformity programs in the United States. His three fellowship training programs — spanning orthopedic and neurosurgical spine, disc replacement, and complex deformity — give him a uniquely comprehensive foundation for managing the full spectrum of kyphosis presentations.

As Co-Chief of Spinal Deformity Surgery at the Och Spine Hospital at NewYork-Presbyterian, he leads one of the busiest deformity programs in New York. He is an active member of the Scoliosis Research Society (SRS) and regularly presents his research at national spine meetings.

Patients travel from across the United States and internationally to see Dr. Sardar for kyphosis correction. Telemedicine consultations are available for patients in NY, NJ, CT, FL, PA, MO, CA, and TX. International patients can contact NewYork-Presbyterian Global Services at +1-212-746-9100.

This page is for educational purposes only and does not constitute individualized medical advice. Please consult a qualified spine specialist to discuss your specific condition and treatment options.