Hyperlordosis

The spine, also called the backbone, is a group of 26 bones that keep the spinal cord safe. The spine allows you to bend over and stand up straight. The spine has some natural curve to it, but when the spine curves too much in the lower back, your child may have hyperlordosis [HAHY-per lawr-DOH-sis], also called swayback.

When you look at a spine that has hyperlordosis in a child who is lying down, you will see a large space underneath their lower back. Their buttocks may also stick out further than normal when they are standing.

Hyperlordosis is similar to other spinal conditions like kyphosis [kahy-FOH-sis], which is an abnormal curvature of the upper spine, or scoliosis [skoh-lee-OH-sis], which is a side-to-side curvature of the spine.

Medical conditions like cerebral palsy [ser-REE-bruhl PAWL-see] and muscular dystrophy [MUS-kyu-luhr DYS-truh-fee] can cause hyperlordosis, and the condition may also be inherited, which means that a child gets it from their parents.

Hyperlordosis is often a part of normal growth, and can sometimes go away as your child continues to develop and get older.

The main symptom of hyperlordosis is a larger-than-normal space under your child’s lower back when they are lying face up. Their buttocks may also jut out more than normal. Hyperlordosis can cause back pain if the curve is very severe.

You should take your child to see their doctor if you notice that they have an abnormally curved lower spine, or if they complain about pain in their lower back. If you notice that other parts of your child’s spine curve too much, they might have a similar condition, like scoliosis or kyphosis, which a doctor should also look at.

There are many causes for hyperlordosis, such as:

• Genetics. A child can inherit hyperlordosis from their parents.
• Injuries to the spine. If your child’s spine is injured, it may cause their back and buttocks to line up the wrong way.
• Birth defects. A spinal deformity can be present at birth; in some cases, this deformity can get worse as the child grows older.
• Spondylolisthesis [spon-dl-oh-lis-THEE-sis]. In this condition, a bone in the spine is moved out of its proper position, and ends up pressing on the bone underneath it. This can cause pain and a misaligned spine.
• Achondroplasia [ey-kon-druh-PLEY-zhuh]. This condition causes dwarfism, which can result in problems with bone growth, including hyperlordosis.
• Muscular Dystrophy [muhs-kyuh-ler DIS-truh-fee]. This is a congenital condition that causes weak muscles and muscle tissue. If the muscles are too weak to hold the spine up straight, your child might develop hyperlordosis.
• Cerebral Palsy [suh-ree-bruhl PAWL-zee]. This disorder causes difficulty with movement, balance, and posture.

If your child’s doctor thinks they have hyperlordosis, they will give your child a physical exam. During this exam, your child’s doctor will look at your child’s spinal curves from the sides, front, and back. Your child’s doctor will also look at how well your child’s hips and shoulders line up, as well as how even their ribs are. In some cases, your child’s doctor may also test your child’s range of motion, reflexes, and strength. Testing your child’s flexibility can help figure out if more treatment is needed.

During this exam, your child may be asked to undress from the waist up so that your child’s doctor can see any unnatural curves. Your doctor may also ask your child to bend over and try to touch their toes. This makes the spine easier to see. Sometimes, the doctor may have your child lie down so they can check for abnormal spaces under your child’s lower back.

There are several technologies that allow your child’s doctor to take pictures of the inside of your child’s body. Depending on what they need to see, your child’s doctor may recommend one of these imaging studies:

• X-ray. Beams of low-dose radiation create pictures of tissues, bones, and organs on film.
• MRI. A magnetic field and radio waves create images of the inside of your child’s body. MRI is very useful for evaluating details of soft-tissue structures, like nerves, in and around your child’s spine.
• CT scan. Computed tomography (CT) uses a computer and x-rays to create cross-sectional views (“slices”) of areas of your child’s body. It’s especially useful for highlighting abnormal tissue and clearly showing bone detail.
• Bone density scan. This scan uses x-rays or ultrasound to measure the amount of bone in a specific area of your child’s body.

In many cases, hyperlordosis is a normal part of the growth process and does not require treatment because it will go away as your child grows up. However, if the hyperlordosis doesn’t go away, or if your child has pain or difficulty bending or standing, treatment may be needed to help restore flexibility. In this case, your doctor might recommend physical therapy or braces that help your child keep their back straight.

Severe cases of hyperlordosis may require surgery, such as a spinal fusion surgery, which joins two or more spinal bones (vertebrae [vur-tuh-brey]) so that they eventually grow into one solid bone. The goal of spinal fusion is to stop abnormal movement and eliminate pain in your child’s back and legs.

Hyperlordosis is hard to prevent because it is often caused by other conditions that are congenital or can’t be predicted. Some cases of hyperlordosis are caused by injuries, which can often be prevented by teaching your child basic safety skills. Teaching your child how to sit straight and have good posture can also help them keep their spine and back healthy.

Children with hyperlordosis [HAHY-per lawr-DOH-sis] have a severe inward curve of the lower back. When you look at a spine that has hyperlordosis in a child who is laying down, you will see a large space underneath their lower back. Their buttocks may also stick out further than normal, or they may have back pain. Hyperlordosis can be caused by other conditions like cerebral palsy or muscular dystrophy. Usually, hyperlordosis goes away as the child gets older and keeps growing.