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Lordotic
Deformities
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Lordosis is a disorder defined by an
excessive inward curve of the spine. It
differs from the spine's normal curves
at the cervical, thoracic, and lumbar
regions, which are, to a degree, either
kyphotic or lordotic. The spine's natural
curves position the head over the pelvis
and work as shock absorbers to distribute
mechanical stress during movement.
Lordosis can be found in all age groups.
It primarily affects the lumbar spine,
but does occur in the neck (cervical).
When found in the lumbar spine, the patient
may appear swayback, the buttocks more
prominent, and in general an exaggerated
posture. A lumbar lordosis can be painful
sometimes affecting movement.
Certain disease processes can adversely
affect the structural integrity of the
spine and contribute to lordosis. Some
common causes include achondroplasia,
discitis, kyphosis, obesity, osteoporosis,
and spondylolisthesis.
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| Causes: |
- Achondroplasia is an inherited bone
growth disorder that may cause a type
of dwarfism.
- Discitis is inflammation of intervertebral
disc space.
- Kyphosis (e.g. humpback) may force
the low back to compensate for the imbalance
created by a curve occurring at a higher
level of the spine (e.g. thoracic).
- Obesity may cause some overweight
people to lean backward to improve balance.
This has a negative impact on posture.
- Osteoporosis is a bone density disease
that may cause vertebrae to loose strength
compromising the spine's structural
integrity.
- Spondylolisthesis occurs when one
vertebra slips forward in relation to
an adjacent vertebra, usually in the
lumbar spine.
- Neuromuscular Lordosis associated
with neuromyopathy or myopathy.
Not every lordosis requires medical treatment.
However, when the curve is rigid (fixed)
or large, medical evaluation is warranted.
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| Diagnosis |
A thorough physical examination reveals
a lot about the health and general fitness
of the patient. The physician will want
to know when the curvature was first noticed,
past progression, and other related symptoms
the patient experiences. The exam provides
a baseline from which the physician can
measure the patient's progress during
treatment. The physical exam may include:
1. Palpation determines spinal abnormalities
by feel.
2. Range of Motion measures the degree
to which a patient can perform movement
of flexion, extension, lateral bending,
and spinal rotation. Asymmetry is also
noted.
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| Neurologic Evaluation |
A neurological evaluation includes
an assessment of the following symptoms: pain,
numbness, paresthesias (e.g. tingling), extremity
sensation and motor function, muscle spasm, weakness,
and bowel/bladder changes.
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| Radiographic |
The patient stands to reveal the entire length
of the spine when PA (posterior/anterior, or
back and front) and Lateral (side) x-rays are
taken. Side bending AP x-rays are sometimes
used to evaluate spinal flexibility. An MRI
may be ordered if the spinal cord has been compromised
(or suspected).
Further, the Cobb Angle Method may be used
to measure the lordotic curve in degrees using
a standard full-length AP x-ray.
Conservative treatment measures may include:
- Analgesics and anti-inflammatory medication.
- Physical therapy enabling the patient to
build strength, flexibility, and increase
range of motion. The therapist may provide
a customized home exercise program.
- Bracing may be used control curve progression
in adolescents.
- Reduction of body weight to ideal.
- Surgery may be considered if the lordotic
curve is severe.
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| Surgery |
Surgical intervention is considered if the
lordotic curve is severe, when neurologic involvement
exists, or conservative treatment has failed
to provide relief.
A spine surgeon decides which surgical procedure
and approach (anterior/posterior, front or back)
is best for the patient. His decisions are based
on the patient's medical history, symptoms,
and radiographic findings.
A variety of surgical treatment options are
utilized. You should discuss what is best for
your condition with your spine surgeon
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Press the button to see the surgical
example |
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TAIWAN SPINE CENTER
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