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    Lordosis

    Swayback

    Lordosis is an increased curving of the spine.

    Considerations

    The spine has three types of curves:

    • Kyphotic curves refer to the outward curve of the thoracic spine (at the level of the ribs).
    • Lordotic curves refer to the inward curve of the lumbar spine (just above the buttocks).
    • Scoliotic curving is a sideways curvature of the spine and is always abnormal.

    A small degree of both kyphotic and lordotic curvature is normal. Too much kyphotic curving causes round shoulders or hunched shoulders (Scheuermann's disease).

    Too much lordotic curving is called swayback (lordosis). Lordosis tends to make the buttocks appear more prominent. Children with significant lordosis will have a significant space beneath their lower back when lying on their back on a hard surface.

    If the lordotic curve is flexible (when the child bends forward the curve reverses itself), it is generally not a concern. If the curve does not move, medical evaluation and treatment are needed.

    Causes

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

    Home Care

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

    When to Contact a Medical Professional

    Call your health care provider if you notice that your child has an exaggerated posture or a curve in the back. The condition should be evaluated to determine if thereis a medical problem.

    What to Expect at Your Office Visit

    The health care provider will perform a physical exam. 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.

    Questions about the child's medical history will be asked, including:

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

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

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

    .

    References

    Spiegel DA, Dormans JP. The spine.In: Kliegman RM,Behrman RE, Jenson HB, Stanton BF, eds.Nelson Textbook of Pediatrics.19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 671.

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    • Skeletal spine

      illustration

    • Lordosis

      illustration

      • Skeletal spine

        illustration

      • Lordosis

        illustration

      Review Date: 2/1/2012

      Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

      The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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