Lordosis, kyphosis, and scoliosis

Learning medicine is hard work! Osmosis makes it easy. It takes your lectures and notes to create
a personalized study plan with exclusive videos, practice questions and flashcards, and so
much more. Try it free today! Lordosis, kyphosis, and scoliosis refer to
curvatures of the spine. Lordosis refers to the normal inward curvatures
of the spine at the cervical and lumbar regions, while kyphosis refers to the normal outward
curvature of the spine specifically at the thoracic region. These terms get used interchangeably with
hyperlordosis and hyperkyphosis, which means that the curves look abnormally pronounced. Finally there’s scoliosis which always refers
to the abnormal sideways curves of the spine. Now, the bony spine is made of vertebral bones,
and there are intervertebral discs that sit between adjacent vertebrae. The spine is made of 33 vertebrae, which can
be divided into 5 regions. The cervical region has 7 vertebrae, the thoracic
region has 12 vertebrae, the lumbar region has 5 vertebrae, the sacral region has 5 vertebrae,
and the small tail-like coccygeal region is made up of 4 fused vertebrae. Normally, the cervical and the lumbar spines
slightly curve inward. This results from the fact that the intervertebral
discs in these two regions are thicker anteriorly than posteriorly, which causes this part of
the spine to lean forward. On the other hand, the thoracic and the sacral
spines are normally curved backward, which is normal kyphosis. Lordosis and kyphosis are typically associated
with underlying conditions. For example, in osteoporosis the bones become
porous and weak, and can develop compression fractures causing the bones to collapse a
bit. This can cause a spinal deformity and can
also impinge on nearby nerves. Misaligned vertebrae can also exert too much
pressure on the intervertebral discs, causing them to degenerate. Other conditions include spondylolisthesis,
in which a vertebrae slips out of its normal position, or conditions like Ehlers-Danlos
syndrome and Marfan syndrome, where bones and connective tissues overgrow, causing spinal
instability. Obesity can also put excess unbalanced weight
on the spine causing it to deform. Other causes include inflammation of the intervertebral
discs, which can happen from overuse due to a sports injury or lifting weights in an inappropriate
way. Lordosis typically affects the lumbar region,
and can specifically result from the trunk flexors and the hip extensors becoming too
weak to balance the action of trunk extensors and hip flexors. When that happens, the lumbar spine gets over-extended,
causing it to progressively curve inwards, causing lumbar lordosis. Lordosis results in an incurved back in the
cervical or lumbar spine. Kyphosis mainly affects the thoracic spine. It usually occurs when the front of the thoracic
vertebrae gets deformed or crushed, causing this part of the spine to excessively bend
forward. Kyphosis typically results in a rounded back
in the thoracic spine, which looks like a hump in the upper back. There are a few types of kyphosis. First, there’s postural kyphosis which arises
from repeated poor posture – like slouching for a long time. Postural kyphosis is most common in young
females. Second, there’s Scheuermann’s kyphosis,
which is where the vertebrae get structurally deformed and become wedge-shaped for an unclear
reason. This is often associated with scoliosis, and
referred to as kyphoscoliosis. Lastly, there’s congenital kyphosis, which
develops when the vertebrae get deformed during fetal development, resulting in a baby that’s
born with kyphosis. In general, if kyphosis is severe, it can
reducing the space in the thoracic cavity, which can compress the heart and prevent the
lungs from fully expanding. Finally, there’s scoliosis, which is when
the spine becomes twisted or develops a sideways curve, resembling an “S” or a “C”
shape, often resulting in uneven shoulders and hips. The majority of the time, the underlying cause
is unclear, and it’s thought that it may be due to a defect in the composition of the
intervertebral discs. These disks have a reduced amount of glycosaminoglycans,
which changes their ability to act as shock absorbers, and causes the spine to get misshapen. Scoliosis is often seen in individuals with
neuromuscular disorders that cause progressive muscle weakness, like cerebral palsy or muscular
dystrophy. In severe scoliosis, there can be a deformity
in the chest cavity, compressing the heart and the lungs similar to what’s seen in
severe kyphosis. In terms of symptoms, spine deformities can
cause mild to severe pain and the stiffened spine can make it difficult to move. In severe kyphosis and scoliosis, the small
thoracic cavity can lead to shortness of breath and an inability to exercise. The diagnosis of lordosis, kyphosis, and scoliosis
are done by physical examination of the back. To figure out the extent the spinal deformity,
the Cobb angle can be measured. That’s the measurement between two lines
drawn perpendicular to the upper border of the uppermost vertebra, and the lower border
of the lowest vertebra involved in the curvature. In addition radiographs can be taken of the
back as well. Treatment of lordosis, kyphosis, and scoliosis
typically includes physical exercises to limit the disease progression and maintain the range
of motion, as well as pain medication when it’s needed. For children and young adolescents, fixing
braces can sometimes help prevent further spinal deformity. In rare situations, surgery may be needed. Alright, as a quick recap. Lordosis and kyphosis are usually secondary
to diseases or injuries which deform the vertebrae and ligaments, such as vertebrae fractures,
spondylolisthesis, Ehlers-Danlos syndrome, and Marfan syndrome. Scoliosis is linked with some neuromuscular
disorders like cerebral palsy or muscular dystrophy. In severe cases, lordosis, kyphosis and scoliosis
can cause back pain, and kyphosis and scoliosis may deform the chest resulting in shortness
of breath, and cardiac failure. Treatment usually involves physical exercises,
braces and pain medication, and surgery in severe cases.

19 comments

  1. Amazing. I have this exact lecture for the finals and I had forgotten about it. Thank you Osmosis for your ever beautiful presentation that makes the information stick for a long time. 😍

  2. Oof I love being rare…
    Anyone here had corrective kyphosis/scoliosis surgery they can tell me about? I’m getting it in a month or so and I’d love to know more about it

  3. How you make the videos sir? By taking still photos or by any software?
    I like you video style very much.

  4. you are contradicting yourself. u said lordosis and kyphosis were normal curvatures of the spine and for that matter that are physiologic curvatures but going forward, u are describing them as pathologic curvatures. u were supposed to describe hyperlordosis and hyperkyphosis rather… thank you

  5. I have scoliosis and the excersizes make my back feel 10x worse and I’m having an appt at an actual back specialist rather than child doctor and I’m so scared and have no idea what they’re gonna say, any advice what to wear what to do before hand what’s gonna happen…? Is there gonna be xrays/Mri on the first appts??

  6. Um, sorry, but EDS isn’t overgrowth of connective tissue I’m pretty sure? It’s a defect in collegian elastin tissue production. There are several types.

Leave a Reply

(*) Required, Your email will not be published