Scoliosis, Lordosis and Kyphosis

The human spine is made up of 33 vertebrae. The first 7 vertebrae are the cervical vertebrae located in the neck region, followed by 12 thoracic vertebrae located in the upper back, the next 5 lumbar vertebrae in the lower back, 5 sacral vertebrae in the sacrum, and the last 4 coccygeal vertebrae which are fused to the tailbone. Between the vertebrae are intervertebral discs that function to absorb impact throughout all activities. Although the spine has limited mobility, it still allows flexion (bending forward), extension (bending backward), lateral flexion (bending sideways), and rotation (twisting).

The spine has natural curves. From the side, it resembles a soft “S” shape but when viewed from the front or back, it appears to be straight. The normal curves are called lordosis and kyphosis. In a normal spine, there are two natural lordoses (cervical spine and lumbar spine) and two natural kyphosis curves (thoracic spine and sacral spine). These curves function to distribute the stress on the body during all activities, be it during rest or movement.

Abnormalities

When these curves are excessive, the terms lordosis and kyphosis can also be used to refer to disorders. Scoliosis is also a disorder that affects the curvature of the spine.

• Scoliosis – there is abnormal curving of the spine either to the right or left (sideways). In most cases, it affects the thoracic spine and is generally seen in children and adolescents during their pubertal growth spurt. It can also be found at birth or in adults. It can range from mild to extremely severe depending on how much the spine curves. Although most cases are mild and do not cause too much discomfort, it can be the cause for anxiety and low self-esteem especially when it occurs in teenagers.
• Lordosis – Abnormal lordosis occurs when there is the excessive inward curvature of the spine. Although most cases involve the lumbar spine, it can involve the cervical spine too. Patients affected by excessive lordosis can appear to be swayback, meaning that their buttocks appear to be more prominent and their posture look exaggerated. It can affect patients of all ages. In more serious cases, excessive lordosis can be a cause of back pain and moving difficulties. There are some spinal disorders that can lead to excessive lordosis, namely: spondylolisthesis, osteoporosis, and some cases of obesity.
• Kyphosis – describes the excessive curvature of the spine causing a rounded back appearance. It can occur due to multiple problems such as bad posture and osteoporosis. In serious cases, the curve may be so dramatic that multiple vertebrae can fracture and collapse. The most common form of excessive kyphosis occurs during adolescent years and is more common in girls compared to boys. It rarely causes pain but treatment may be required for more serious cases. Most cases can be managed by an exercise program that helps improve posture and prevents progression of the condition. If the curve is very severe, surgery should be considered as an option as stabilization of the spine will help with pain relief and function.

References

Scoliosis & Kyphosis. Orthopaedic & Neurosurgery Specialists. Accessed 7/15/2017.

Eidelson SG. Normal curves of your spine. Spine Universe. Accessed 7/15/2017.