What is lordosis?
A normal spine, when viewed from behind appears straight. However, a spine affected by lordosis shows evidence of a curvature of the back bones (vertebrae) in the lower back area. This gives the child a "swayback" appearance.
What causes lordosis?
The cause of lordosis has been linked to achondroplasia and spondylolisthesis. However, lordosis may be associated with poor posture, a congenital (present at birth) problem with the vertebrae, neuromuscular problems, back surgery, pelvis problem, or a hip problem.
What are the symptoms of lordosis?
Each child may experience symptoms differently. The major clinical feature of lordosis is a prominence of the buttocks. Symptoms will vary depending if lordosis happens with other defects. These include muscular dystrophy, developmental dysplasia of the hip, or neuromuscular disorders.
Back pain, pain down the legs, and changes in bowel and bladder habits are not commonly associated with lordosis. A child experiencing these types of symptoms needs immediate medical evaluation by a healthcare provider.
The symptoms of lordosis may resemble other spinal conditions or deformities, or may be a result of an injury or infection. Always talk with your child's healthcare provider for a diagnosis.
How is lordosis diagnosed?
The healthcare provider makes the diagnosis of lordosis with a complete medical history of the child, physical exam, and diagnostic tests. Your child's healthcare provider obtains a complete prenatal and birth history of the child and asks if other family members are known to have lordosis.
Diagnostic procedures may include:
X-rays. This diagnostic test uses invisible electromagnetic energy beams to produce images of internal tissues, bones, and organs onto film. This test is used to measure and evaluate the curve. With the use of a full-spine X-ray, the healthcare provider or radiologist measures the angle of the spinal curve. A determination for treatment can often be made based on this measurement.
Bone scans. Bone scans are a nuclear imaging method to evaluate any degenerative and/or arthritic changes in the joints; to detect bone diseases and tumors; to determine the cause of bone pain or inflammation. This test is to rule out any infection or fractures.
Magnetic resonance imaging (MRI). This diagnostic procedure uses a combination of large magnets and a computer to produce detailed images of organs and structures within the body. This test is done to rule out any associated abnormalities of the spinal cord and nerves.
Computed tomography (CT) scan. This is an imaging test that uses X-rays and a computer to make detailed images of the body. A CT scan shows details of the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
Early detection of lordosis is important for successful treatment. Pediatricians or family healthcare providers, and even some school programs, routinely look for signs that lordosis may be present.
What is the treatment for lordosis?
Specific treatment for lordosis will be discussed with you by your child's healthcare provider based on:
Your child's age, overall health, and medical history
The underlying cause of the lordosis
The extent of the condition
Your child's tolerance for specific medicines, procedures, or therapies
Expectations for the course of the condition
Your opinion or preference
The goal of treatment is to stop the progression of the curve and minimize deformity. Management of lordosis will depend on the cause of the lordosis. Simple exercises may be sufficient if lordosis is associated with poor posture. However, lordosis occurring as a result of a hip problem may be treated as a part of the hip problem.
What is the long-term outlook for a child with lordosis?
The management of lordosis is individualized for each child depending on his or her age, amount of curvature, and amount of skeletal growth remaining. Lordosis may need frequent exams by your child's healthcare provider to monitor the curve as your child grows and develops. Finding the condition early is important.