Hi. My name is Dr. John Shim, and I would like to discuss a very specific topic that is
often a finding on x-rays or MRIs of the spine. The term is lordosis. It basically
describes the backward curvature of the spine. To go back to some basic anatomy,
the whole spine, from the head to the tailbone is composed of two backward
oriented curves, and two forward oriented curves. If you look at the side view of
the whole spine, just below the head, is your neck. In what is considered normal
anatomy, the neck curves backwards. As stated before, this backward curvature is
called lordosis. The upper back, or the thoracic spine then curves forwards. This
forward curvature of the spine, which is called Kyphosis, also allows development
of a concave space in the upper body, which then forms a protective cage with
the ribs to house structures such as the lungs, the heart, and the liver. The lower
back, which is called a lumbar spine, then curves backwards again. Then at the
bottom of your spine, the so called sacrum, forms another forward curvature,
and becomes another protected space with the pelvic bones to house your bowels.
The net effect of these four curves is that it allows your head to remain balanced
over your shoulders, and the center of gravity fall over the top of your pelvis.
When you stand normally, the center of your weight, or so-called sagittal
balance allows you to be most efficiently standing, without expending
too much energy trying to balance your body parts over the legs.
So naturally, we assume that the neck, and the lower back, should have a normal
lordosis curvature. Most people do not get x-rays of their spine when they are
not hurting. So when people have pain, one of the tests often ordered by your
doctor is an x-ray. Our radiologists will read the x-rays, and if there is a lack of
curvature, the report would indicate lack of
lordosis. Because the person getting the x-ray is in pain, and there's a finding
of loss or lack of lordosis, the common sense assumption, is, that this loss of
lordosis or straightening of the spine is an indication of some sort of injury
or pain. But this is not the only reason people have lack of lordosis. One reason
a person would have loss of lordosis may simply be positioning. Some people just
take x-rays with their neck or back straight. Another reason a person can
have loss of lordosis is secondary to the natural degenerative process. As the discs
narrow, there is a straightening of the spine that occurs over time. But the most
surprising reason why people have lack of lordosis, or straightening of the
spine is because that is just the way they are. Multiple research studies have
identified loss or lack of lordosis or straightening of the spine is a normal
variant of people's anatomies. X-Rays of painfree people will often demonstrate
this loss of lordosis. So while as a practicing doctor I do believe loss of
lordosis may be a sign of pain or injury, I also know lack of lordosis or
straightening of the spine may be just a normal degenerative process, or may be
an issue of positioning while taking the x-ray, or may be the normal anatomy of
that person. I hope I did not confuse your understanding about lordosis. While
it may be considered a normal finding, lack of it may also be normal. This is
Dr. John Shim and I thank you for watching the video.