Deformities of the spine: Lordosis, Kyphosis, and Scoliosis

ICD-9: 737.20 LORDOSIS

ICD-9: 737.10 KYPHOSIS

ICD-9: 737.30 SCOLIOSIS

Video: How to Correct a Scoliosis With Exercise and Stretching

Description

⚡ Lordosis ⚡ is an abnormal inward curvature of the lumbar or lower spine. This condition is commonly called “swayback.” Kyphosis is an abnormal outward curvature of the upper thoracic vertebrae. Commonly, this curvature is known as “humpback” or “round back.” Scoliosis is an abnormal sideward curvature of the spine to either the left or right. Some rotation of a portion of the vertebral column also may occur. Scoliosis often occurs in combination with kyphosis and lordosis. These three spinal deformities may affect children as well as adults.

READ:   Lordosis: Causes, Treatments, and Risks

Spinal curvatures

FIGURE. Spinal curvatures

Etiology

Lordosis, kyphosis, and scoliosis may be caused by a variety of problems, including congenital spinal defects, poor posture, a discrepancy in leg lengths (especially in scoliosis), and growth retardation or a vascular disturbance in the epiphysis of the thoracic vertebrae during periods of rapid growth. Kyphosis may be the result of collapsed vertebrae from degenerative arthritis, or it may occur following a history of excessive sport activity. Obesity and osteoporosis can be contributing factors for lordosis. These three spinal deformities also may result from tumors, trauma, infection, osteoarthritis, tuberculosis, endocrine disorders such as Cushing disease, prolonged steroid therapy, and degeneration of the spine associated with aging. Lordosis, kyphosis, and scoliosis also may be idiopathic.

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Signs and Symptoms

The onset of lordosis, kyphosis, and scoliosis frequently is insidious. Signs and symptoms may eventually include chronic fatigue and backache. Scoliosis is often detected by individuals when they notice that their clothing seems longer on one side than on the other. Or they may notice when looking in a mirror that the height of their hips and shoulders appears uneven.

Diagnostic Procedures

Physical examination and anterior, posterior, and lateral x-rays of the spine are the most commonly used procedures to detect these spinal deformities.

Treatment

Treatment varies according to the nature and severity of the spinal curvature, the age of onset, and the underlying cause of the disorder. The goal is to slow the progression of the disease. Physical therapy, exercise, and back braces may all play a role in the treatment of these conditions. Spinal bracing, if closely watched and properly constructed and fitted, may be able to halt the progression of the curve in scoliosis. Surgery may be necessary, however, in cases of adolescent scoliosis if the curvature seriously interferes with mobility or breathing. Spinal fusion, using bone grafts and metal rods, is sometimes performed to straighten the spine in this situation. Surgery is rarely necessary for correction of kyphosis. Analgesics may be prescribed to alleviate the pain that frequently accompanies these disorders.

READ:   Spine Health. PROCEDURE 11 — SUSTAINED ROTATION/MOBILISATION IN FLEXION

Complementary Therapy

Kyphosis may respond well to massage. Physical therapy and exercises to strengthen abdominal muscles can decrease lumbar lordosis. Hamstring stretch can reduce muscle contractures, or a permanent shortening of muscle. Stress proper posture. In scoliosis, it is helpful for individuals to turn their whole body, rather than just their head, when looking to the side; yoga is helpful to some.

CLIENT COMMUNICATION

Emotional support is essential. Instruct clients on the use of any brace and to avoid vigorous sports. Meticulous skin care is important to prevent irritation and skin breakdown due to the brace rubbing against the skin.

Prognosis

The prognosis of an individual with lordosis, kyphosis, or scoliosis depends on the underlying cause of the particular disease, how early it is detected, and whether it responds to treatment. In some cases, a spinal deformity may be arrested but not corrected. Pulmonary insufficiency, degenerative arthritis of the spine, and sciatica may arise as complications of spinal deformities.

READ:   Spine Health. PROCEDURE 4 — EXTENSION IN LYING WITH BELT FIXATION

Prevention

Prevention of lordosis, kyphosis, and scoliosis includes correction of any underlying cause and maintaining good posture. Weight loss can reduce the risk of lordosis. Scoliosis screening in public schools is mandated by law in some states.

Lordosis

 

TREATMENT OF THE DERANGEMENT SYNDROME Of all patients with low back pain those having derangement of the intervertebral disc are the most interesting and rewarding to treat. As in dysfunction, it is essential in derangement that from the very first treatment correction of the sitting posture be achieved, but in the early and acute stages of derangement emphasis is placed on the maintenance of lordosis rather than the obtaining of the correct posture. Failure in this respect means failure of what otherwise might be a successful reduction of the derangement. So often it occurs that a patient describes a significant relief from pain and is visibly improved immediately following treatment, but later that same day after sitting for some time he is unable to straighten up on rising from sitting and the symptoms have returned just as they were before treatment. Usually the patient clearly understands the dangers of bending and stooping and carefully avoids these movements. But the hidden dangers of sustained flexion incurred in t...
Spine Health. PROCEDURE 11 — SUSTAINED ROTATION/MOBILISATION IN FLEXION The patient lies supine on the couch, and the therapist stands on the side to which the legs are to be drawn, facing the head end of the couch. The patient’s far shoulder is held firmly on the couch by the therapist’s near hand, providing fixation and stabilisation. With the other hand the therapist flexes the patient’s hips and knees to a rightangle and carries them towards himself, causing the lumbar spine to rotate. With the patient’s ankles resting on the therapist’s thigh the knees are allowed to sink as far as possible and the legs are permitted to rest in that extreme position. The lumbar spine is now hanging on its ligaments in a position which combines side bending and rotation. By pushing the knees further towards the floor the therapist applies overpressure to take up the remaining slack in the lumbar spine. Depending on the purpose for which the procedure is used, the position of extreme rotation is maintained for a shorter or longer period. Fig. Sustained rotation/mob...
Lordosis Exercises: For Core and Hips Hyperlordosis, simply referred to as lordosis, is an excessive inward curvature of the lower back, sometimes referred to as swayback. It can occur in people of all ages and is more common in young children and women. It may occur in women during and after pregnancy, or in people who sit for extended periods of time. It can cause symptoms like low back pain, nerve problems, and is associated with more serious conditions like spondylolisthesis. In some people, lordosis is caused by poor pelvis position. When the pelvis tilts too far forward, it affects the curvature of the lower back, causing the person to look like they are sticking their bottom out. A small amount of lordosis is normal, but an excessive curve can cause problems over time. Lordosis is often due to an imbalance between the muscles surrounding the pelvic bones. Weak muscles used to lift the leg forward (hip flexors) combined with tight muscles used to arch the back (back extensors), can cause an increased pelvic ...
The Derangement Syndrome Of all mechanical low back problems that are encountered in general medical practise, mechanical derangement of the intervertebral disc is potentially the most disabling. It is my belief that in the lumbar spine, if in no other area, disturbance of the intervertebral disc mechanism is responsible for the production of symptoms in as many as ninety-five percent of our patients. Twenty-five years of clinical observation and treatment of lumbar conditions have convinced me that certain phenomena and the various movements which affect them, can occur only because of the hydrostatic properties invested in the intervertebral disc. For thirty years Cyriax has attributed lumbar pain to internal derangement of the intervertebral disc mechanism. He has outlined the cause of lumbago, and proposed that pain of a slow onset is likely to be produced by a nuclear protrusion while that of a sudden onset is caused by a displaced annular fragment. Although at present we are unable to prove either of ...
Spine Health. PROCEDURE 3 — EXTENSION IN LYING The patient, already lying prone, places the hands (palms down) near the shoulders as for the traditional press-up exercise. He now presses the top half of his body up by straightening the arms, while the bottom half, from the pelvis down is allowed to sag with gravity. The top half of the body is then lowered and the exercise is repeated about ten times. The first two or three movements should be carried out with some caution, but once these are found to be safe the remaining extension stresses may become successively stronger until the last movement is made to the maximum possible extension range. If the first series of exercises appears beneficial, then a second series may be indicated. More vigour can be applied and a better effect will be obtained if the last two or three extension stresses are sustained for a few seconds. It is essential to obtain the maximum elevation by the tenth excursion and once obtained the lumbar spine should be permitted to relax into the most extreme ...