Lordosis

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Alternative names
Swayback

Definition
Lordosis is an increased curvature of the normally curved lumbar spine.

Considerations
The spine has three types of curves:

• Kyphotic, which typically refers to the outward curve of the thoracic spine (at the level of the ribs)
  
• Lordotic, which refers to the inward curve of the lumbar spine (just above the buttocks)
  
• Scoliotic, which is a sideways curvature of the spine and which is always abnormal

A small degree of both kyphotic and lordotic curvature is normal. Exaggeration of the kyphotic curve is described as round shoulders or hunched shoulders (the medical term is Scheuermann’s disease). Exaggeration of the lordotic curve is often called swayback (the medical term is lordosis).

This curvature tends to make the buttocks appear more prominent. A child with marked lordosis, when laid on his back on a hard surface, will have a space beneath his lower back and the surface.

If the lordotic curve is flexible (when the child bends forward the curve reverses itself) it is generally of little medical significance. If the curve is fixed, it suggests the need for medical evaluation and intervention.

Common Causes

• Benign juvenile lordosis (not medically significant)
  
• Achondroplasia
  
• Spondylolisthesis
  
• Diskitis

Home Care
If the back is flexible, lordosis is usually not treated and will not progress or cause problems.

Call your health care provider if

• You notice that your child has an exaggerated posture or a misaligned back. This condition should be evaluated to determine if there is a medically significant cause.

What to expect at your health care provider’s office
The medical history will be obtained and a physical examination performed.

Medical history questions documenting lordosis in detail may include:

• Time pattern
  o When did it you first notice the excessive curvature?
  o Is it getting worse or more noticeable?
  o Is it ever better or worse than when examined by the health care provider?
  
• Quality
  o How would you describe the curvature?
  o Does the amount of curvature seem to change?
  
• Other
  o What other symptoms are also present?

Physical examination:
The child may be asked to bend forward, to the side, and to lie flat on a table so that the spine can be examined in a variety of positions.

In some cases, particularly if the curvature seems “fixed” (not bendable), the following or other diagnostic tests may be recommended:

• Spine X-ray
  
• Lumbosacral spine X-ray
  
• Other tests to rule out suspected disorders causing the condition

After seeing your health care provider:
You may want to add a diagnosis related to lordosis to your personal medical record.

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