Lordosis is an increased curving of the spine.
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.
Hyperlordosis: > 70°
Normal lordosisl: 31°-50°
Lumbar kyphosis: < 10°
A small degree of both kyphotic and lordotic curvature is normal. A large kyphotic curvature causes round shoulders or hunched shoulders (Scheuermann’s disease).
Presentation/Signs and Symptoms
- Postural deformity
- Neck and back pain, generally increased with prolonged sitting/standing
- There may be radicular symptoms
- Functional limitation in more severe cases
- Frequently observed postural abnormalities
- Forward head posture
- Head anterior to shoulders
- Middle cervical spine extended
- Lower cervical segments flexed
- Kyphosis-lordosis posture
- Anterior pelvic tilt
- Exaggerated lumbar lordosis
- Mild hip flexion
- Flat back posture
- Flexion of upper thoracic segments
- Posterior pelvic tilt
- Diminished lumbosacral angle
- Sway back posture
- Forward head
- Increased flexion of upper thoracic segments
- Posterior shift of upper thoracic region
- Entire pelvis shifted anteriorly
- Hips pushed into extension
Too much lordotic curving is called swayback. 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.
- Benign juvenile lordotic curve (not medically significant)