Lordosis
Encyclopedia
Lordosis is a medical term used to describe an inward curvature of a portion of the lumbar
Lumbar
In tetrapod anatomy, lumbar is an adjective that means of or pertaining to the abdominal segment of the torso, between the diaphragm and the sacrum ...

 and cervical
Cervical vertebrae
In vertebrates, cervical vertebrae are those vertebrae immediately inferior to the skull.Thoracic vertebrae in all mammalian species are defined as those vertebrae that also carry a pair of ribs, and lie caudal to the cervical vertebrae. Further caudally follow the lumbar vertebrae, which also...

 vertebral column
Vertebral column
In human anatomy, the vertebral column is a column usually consisting of 24 articulating vertebrae, and 9 fused vertebrae in the sacrum and the coccyx. It is situated in the dorsal aspect of the torso, separated by intervertebral discs...

. Two segments of the vertebral column, namely cervical and lumbar, are normally lordotic, that is, they are set in a curve that has its convexity anteriorly (the front) and concavity posteriorly (behind), in the context of human anatomy. When referring to the anatomy of other mammals, the direction of the curve is termed ventral. Curvature in the opposite direction, that is, apex posteriorly (humans) or dorsally (mammals) is termed kyphosis
Kyphosis
Kyphosis , also called roundback or Kelso's hunchback, is a condition of over-curvature of the thoracic vertebrae...

. Excessive or hyperlordosis is commonly referred to as swayback or saddle back, a term that originates from the similar condition that arises in some horses.

A major factor of lordosis is anterior pelvic tilt, when the pelvis tips forward when resting on top of the femurs.

Cause

A consequence of the normal lordotic curvatures of the vertebral column, (also known as secondary curvatures) is that there are differences in thickness between the anterior and posterior part of the intervertebral disc
Intervertebral disc
Intervertebral discs lie between adjacent vertebrae in the spine. Each disc forms a cartilaginous joint to allow slight movement of the vertebrae, and acts as a ligament to hold the vertebrae together.-Structure:...

. Lordosis may also increase at puberty sometimes not becoming evident until the early or mid-20s. Imbalances in muscle strength and length are also a cause, such as weak hamstring
Hamstring
In human anatomy, the hamstring refers to any one of the three posterior thigh muscles, or to the tendons that make up the borders of the space behind the knee. In modern anatomical contexts, however, they usually refer to the posterior thigh muscles, or the tendons of the semitendinosus, the...

s, or tight hip flexors
Hip flexors
In human anatomy, the hip flexors are a group of skeletal muscles that act to flex the femur onto the lumbo-pelvic complex, i.e., pull the knee upward....

 (psoas).

Excessive lordotic curvature is also called hyperlordosis, hollow back, saddle back, and swayback. Common causes of excessive lordosis include tight low back
Human back
The human back is the large posterior area of the human body, rising from the top of the buttocks to the back of the neck and the shoulders. It is the surface opposite to the chest, its height being defined by the vertebral column and its breadth being supported by the ribcage and shoulders...

 muscles, excessive visceral fat, and pregnancy. Although lordosis gives an impression of a stronger back, incongruently it can lead to moderate to severe lower back pain. Rickets
Rickets
Rickets is a softening of bones in children due to deficiency or impaired metabolism of vitamin D, magnesium , phosphorus or calcium, potentially leading to fractures and deformity. Rickets is among the most frequent childhood diseases in many developing countries...

, a vitamin D
Vitamin D
Vitamin D is a group of fat-soluble secosteroids. In humans, vitamin D is unique both because it functions as a prohormone and because the body can synthesize it when sun exposure is adequate ....

 deficiency in children, can cause lumbar
Lumbar
In tetrapod anatomy, lumbar is an adjective that means of or pertaining to the abdominal segment of the torso, between the diaphragm and the sacrum ...

 lordosis.

Treatment

Lordosis of the lower back may be treated by strengthening the hip extensors on the back of the thighs, and by stretching the hip flexors on the front of the thighs. Too much importance has been attributed to the abdominal muscles in maintaining a neutral spine position. They may help by pushing the internal organs against the spine hence alleviating the lumbar curvature but they can't rotate the pelvis backward while in a standing position. Also the lumbar erector spinae is not able to rotate the pelvis forward while standing, hence its strengthening is not to be avoided during lordosis treatment. Only the muscles on the front and on the back of the thighs can rotate the pelvis forward or backward while in a standing position because they can discharge the force on the ground through the legs and feet. Abdominal muscles and erector spinae can't discharge force on an anchor point while standing, unless one is holding his hands somewhere, hence their function will be to flex or extend the torso, not the hip. Back hyper-extensions on a Roman chair
Roman chair
The Roman chair is a piece of exercise equipment. The equipment is mainly used for the lower back, but can also target the gluteal muscles and the abdominals. How the equipment is defined, and what the 'Roman chair exercise' is specifically, is an issue that is not clear.-Exercises:Various...

 or inflatable ball will strengthen all the posterior chain and will treat lordosis. So too will stiff legged deadlifts and supine hip lifts and any other similar movement strengthening the posterior chain without involving the hip flexors in the front of the thighs. Abdominal exercises could be avoided altogether if they stimulate too much the psoas and the other hip flexors. Strengthening of the hip extensors, which are on the back of the thighs, and optionally stretching of the hip flexors, which are on the front of the thighs, will be enough to treat a lordosis in quite a short time. Anti-inflammatory pain relievers may be taken as directed for short-term relief. Physical therapy effectively treats 70% of back pain cases due to scoliosis
Scoliosis
Scoliosis is a medical condition in which a person's spine is curved from side to side. Although it is a complex three-dimensional deformity, on an X-ray, viewed from the rear, the spine of an individual with scoliosis may look more like an "S" or a "C" than a straight line...

, kyphosis, lordosis, and bad posture. Measurement and diagnosis of lumbar lordosis can be difficult. Obliteration of vertebral end-plate landmarks by interbody fusion may make the traditional measurement of segmental lumbar lordosis more difficult. Because the L4-L5 and L5-S1 levels are most commonly involved in fusion procedures, or arthrodesis, and contribute to normal lumbar lordosis, it is helpful to identify a reproducible and accurate means of measuring segmental lordosis at these levels.
Hypo-lordosis is more common than Hyper-lordosis. Hypo-lordosis can be corrected non-surgically through rehabilitation exercises. Many different techniques exist to accomplish this correction. These exercises, if done correctly, may reduce symptoms in those with the typical presentation in 3-6 months. The type of practitioner that usually offers this type of treatment is usually a Chiropractor, some physical therapists do this type of rehab but it is not very common.

In non-human animals

Lordosis is seen in non-humans, in particular horse
Horse
The horse is one of two extant subspecies of Equus ferus, or the wild horse. It is a single-hooved mammal belonging to the taxonomic family Equidae. The horse has evolved over the past 45 to 55 million years from a small multi-toed creature into the large, single-toed animal of today...

s and other equines
Equus (genus)
Equus is a genus of animals in the family Equidae that includes horses, donkeys, and zebras. Within Equidae, Equus is the only extant genus. Like Equidae more broadly, Equus has numerous extinct species known only from fossils. This article deals primarily with the extant species.The term equine...

. Usually called "swayback," soft back, or low back, it is an undesirable conformation
Equine conformation
Equine conformation evaluates the degree of correctness of a horse's bone structure, musculature, and its body proportions in relation to each other. Undesirable conformation can limit the ability to perform a specific task. Although there are several universal "faults," a horse's conformation is...

 trait. Swayback is caused in part from a loss of muscle tone in both the back and abdominal muscles, plus a weakening and stretching of the ligaments. As in humans, it may be influenced by bearing young; it is sometimes seen in a broodmare that has had multiple foals. However, it is also common in older horses whose age leads to loss of muscle tone and stretched ligaments. It also occurs due to overuse or injury to the muscles and ligaments from excess work or loads, or from premature work
Working animal
A working animal is an animal, usually domesticated, that is kept by humans and trained to perform tasks. They may be close members of the family, such as guide or service dogs, or they may be animals trained strictly to perform a job, such as logging elephants. They may also be used for milk, a...

 placed upon an immature animal. Equines with too long a back
Back (horse)
The back describes the area of horse anatomy where the saddle goes, and in popular usage extends to include the loin or lumbar region behind the thoracic vertebrae that also is crucial to a horse's weight-carrying ability. These two sections of the vertebral column beginning at the withers, the...

 are more prone to the condition than those with a short back, but as a longer back is also linked to smoother gaits
Horse gait
Horse gaits are the various ways in which a horse can move, either naturally or as a result of specialized training by humans.-Classification:...

, the trait is sometimes encouraged by selective breeding
Selective breeding
Selective breeding is the process of breeding plants and animals for particular genetic traits. Typically, strains that are selectively bred are domesticated, and the breeding is sometimes done by a professional breeder. Bred animals are known as breeds, while bred plants are known as varieties,...

. It has been found to have a hereditary basis in the American Saddlebred
American Saddlebred
The American Saddlebred, formerly known as the American Saddle Horse, is a breed of horse that was developed in Kentucky by plantation owners. Today, in the horse show world, they are most commonly seen under saddle in Saddle seat style riding, and in various types of driving, including pleasure...

 breed, transmitted via a recessive mode
Dominance relationship
Dominance in genetics is a relationship between two variant forms of a single gene, in which one allele masks the effect of the other in influencing some trait. In the simplest case, if a gene exists in two allelic forms , three combinations of alleles are possible: AA, AB, and BB...

 of inheritance. Research into the genetics underlying the condition has several values beyond just the Saddlebred breed as it may "serve as a model for investigating congenital skeletal deformities in horses and other species."

Other

Lordosis behavior
Lordosis behavior
Lordosis behavior, or mammalian lordosis, is a sexual response in mammals, such as mice and cats, that consists of a ventral arching of the spine. During lordosis, the spine curves so that the apex points in the ventral direction. That is, the spine arches inward toward the abdomen.Lordosis aids in...

 refers to the position that some mammalian females (including cats, mice, and rats) display when they are ready to mate ("in heat"). The term is also used to describe mounting behavior in mammalian males.

In radiology
Radiology
Radiology is a medical specialty that employs the use of imaging to both diagnose and treat disease visualized within the human body. Radiologists use an array of imaging technologies to diagnose or treat diseases...

, a lordotic view is an X-ray taken of a patient leaning backwards.

See also

  • Lordosis behavior
    Lordosis behavior
    Lordosis behavior, or mammalian lordosis, is a sexual response in mammals, such as mice and cats, that consists of a ventral arching of the spine. During lordosis, the spine curves so that the apex points in the ventral direction. That is, the spine arches inward toward the abdomen.Lordosis aids in...

  • Kyphosis
    Kyphosis
    Kyphosis , also called roundback or Kelso's hunchback, is a condition of over-curvature of the thoracic vertebrae...

  • Scoliosis
    Scoliosis
    Scoliosis is a medical condition in which a person's spine is curved from side to side. Although it is a complex three-dimensional deformity, on an X-ray, viewed from the rear, the spine of an individual with scoliosis may look more like an "S" or a "C" than a straight line...

  • Hyperkyphosis
    Hyperkyphosis
    Hyperkyphosis, colloquially called “dowager’s hump,” refers to excessive kyphotic, or anteriorly concave, curvature of the thoracic region of the spine. A kyphosis angle over 40° - the 95th percentile value for young adults - is currently used to define hyperkyphosis.-Causes:In adults, osteoporosis...

  • Kyphoscoliosis
    Kyphoscoliosis
    Kyphoscoliosis describes an abnormal curvature of the spine in both a coronal and sagittal plane. It is a combination of kyphosis and scoliosis. Kyphoscoliosis is a musculoskeletal disorder causing chronic underventilation of the lungs and may be one of the major causes of pulmonary hypertension...

  • Pott's disease
    Pott's disease
    Pott's disease is a presentation of extrapulmonary tuberculosis that affects the spine, a kind of tuberculous arthritis of the intervertebral joints...


External links

The source of this article is wikipedia, the free encyclopedia.  The text of this article is licensed under the GFDL.
 
x
OK