(Swayback; Saddle Back)
Definition
Definition
Lordosis is a normal inward curve in the lower back and neck. Hyperlordosis, or swayback, occurs when the angle of the inward curve is exaggerated. The sooner hyperlordosis is treated, the better the outcome.
HyperlordosisThe shadowed spine to the left shows ideal lordosis.
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Causes
Causes
The exact cause of hyperlordosis is often unknown.
Risk Factors
Risk Factors
Factors that may increase your chance of hyperlordosis include:
- Achondroplasia —a genetic disorder that results in abnormal cartilage growth and dwarfism
- Spondylolisthesis —displaced vertebrae of back
- Neuromuscular disorders such as muscular dystrophy or cerebral palsy
- Congenital abnormalities of the spine
- Back surgery
- Hip disorders
- Poor posture
- Abnormal vertebral bodies—more commonly found in children with hyperlordosis
- Hyperkyphosis —an exaggerated outward curve of the thoracic spine
- Osteoporosis
- Disc problems
- Obesity
Symptoms
Symptoms
Often times there are no symptoms with hyperlordosis. Depending on the degree of abnormal curving, you may experience back pain.
Diagnosis
Diagnosis
Your doctor will ask about your symptoms and medical history. A physical exam will be done. During the physical, your doctor may ask you to bend and move your back. Hyperlordosis can be seen during the exam. Some tests may be done to rule out or confirm other conditions that may be causing hyperlordosis.
Your doctor may recommend imaging tests to see the spinal curve and the structures around it. These may include:
Treatment
Treatment
For mild cases of hyperlordosis, treatment is often not necessary. You may need additional treatment to resolve any underlying conditions that contribute to your hyperkyphosis. Your doctor may refer to you a specialist who treats spinal disorders.
Options include the following:
Physical Therapy
Your doctor may refer you to a therapist to learn specific exercises. Exercises may be used to strengthen muscles and increase range of motion. You may also be taught how to maintain a correct posture.
Medications
Medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) may be given for discomfort or to decrease swelling.
Back Brace
Braces are sometimes used with children. The brace can make sure the curve doesn’t worsen as they grow.
Surgery
Surgery may be used when the curve is severe, progresses, or when other treatment methods fail. The goal of surgery is to correct the exaggeration of the curve. The spine is corrected with a metal rod, hooks, or screws in the back bones. Surgeons also use a bone graft to promote new growth and stability.
Prevention
Prevention
There are no current guidelines to prevent hyperlordosis.
RESOURCES:
Ortho Info—American Academy of Orthopaedic Surgeons http://www.orthoinfo.org
CANADIAN RESOURCES:
Canadian Orthopaedic Foundation http://www.canorth.org/
References:
http://www.ebscohost.com/dynamed
Updated November 22, 2013. Accessed February 7, 2014.
Lordosis. Seattle Children’s Hospital website. Available at:
http://www.seattlechildrens.org/medical-conditions/bone-joint-muscle-conditions/spinal-conditions-treatment/scoliosis/lordosis
Accessed February 7, 2014.
Lordosis in children. Boston Children’s Hospital website. Available at:
http://www.childrenshospital.org/az/Site1095/mainpageS1095P0.html
Accessed February 7, 2014.
Spine basics. American Academy of Orthopaedic Surgeons Ortho Info website. Available at:
http://orthoinfo.aaos.org/topic.cfm?topic=A00575
Updated December 2013. Accessed February 7, 2014.
Swayback (Lordosis). Cedars Sinai Health System website. Available at:
http://www.cedars-sinai.edu/Patients/Health-Conditions/Swayback-Lordosis.aspx
Accessed February 7, 2014.
Vialle R, Khouri N, et al. Lumbar hyperlordosis of neuromuscular origin: pathophysiology and surgical strategy for correction. Int Orthop. 2007;31(4):513-523.
Last Updated: 12/20/2014