Degenerative changes in aging spine is not only limited at the facet joints and intervertebral disc. Osteoporosis , fatty degeneration in the paravertebral muscles may cause change of physiologic curves of the spine. This changes may lead pulmonary and cardiac dysfunctions that may decrease quality of life. The most common location of these changes is seen in thoracal region and cause hyperkyphosis. Treatment options of hyperkyphosis varies from medical and conservative treatment to advanced surgical treatment techniques. In this review we especially focused on clinic presentation, physiopathology and treatment options of the thoracic hyperkyphosis.