Definition

Lordosis is an increased curving of the spine.

Alternative Names

Swayback

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.

Common 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.

Call your health care provider if

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 there is a medical problem.

What to expect at your health care provider's office

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, Hosalkar HS, Dormans JP. The spine. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier;2007:chap 678.

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