Abnormal Spinal Curvatures: Scoliosis, Kyphosis and Lordosis Explained

Guide on abnormal spinal curvatures, including scoliosis, kyphosis and lordosis, with definitions, causes, clinical features and types.

SCOLIOSIS: Scoliosis is defined as the lateral curvature of the spine in the upright position in the coronal plane.

The lateral curvature is usually accompanied by some rotational deformity.

Nature has designed four physiological curves in the so-called erect spine, cervical and lumbar lordosis, dorsal curve in the thoracic spine and the sacral region. Thus, when the spine develops a lateral curve, it is abnormal called Scoliosis. It throws the well-adjusted spinal mechanism out of gear and poses the following problems:

Clinical Features:

1. A cosmetically unacceptable deformity.
2. Deranges the load and force transmission mechanism through the spine.
3. Jeopardizes the functions of vital organs like lungs, heart by overcrowding the ribs.
4. Managing it is cumbersome and unrewarding experience most of the times.

Types

Structural scoliosis: In structural scoliosis, the curves are fixed and nonflexible and fail to correct with side bending.

Nonstructural scoliosis: In nonstructural scoliosis, the curves are flexible and readily correctible with side bending.

KYPHOSIS

Definition: It is defined as increase in normal posterior convexity of the thoracic spine and is referred to as ‘hyperkyphosis’.

Clinical Features:

1. Excessive inward curvature of the lumbar spine.
2. Swayback posture (abdomen protrudes forward).
3. Prominent buttocks.
4. Increased lumbar arch.
5. Forward tilt of the pelvis (anterior pelvic tilt).
6. Low back pain or discomfort.
7. Muscle tightness in the lower back and hip flexors.
8. Weak abdominal and gluteal muscles.
9. Difficulty standing for long periods.
10. Fatigue after prolonged walking or standing.
11. Reduced flexibility of the lumbar spine.
12. In severe cases, nerve compression causing numbness or tingling in the legs.

Types:

1. Knuckle: Prominence of single spinous process indicating collapse of single vertebra, e.g. TB spine/Kummel’s disease, etc.
2. Angular: Two to three vertebral body are collapsed, e.g. late stage of TB, secondary carcinoma, etc.
3. Round: Several vertebrae are involved and hence gives a round appearance, e.g. in children—Scheurmann’s disease, in old age—senile kyphosis.

LORDOSIS

Definition: Lordosis is the normal inward curvature of the spine, mainly seen in the cervical (neck) and lumbar (lower back) regions.

Clinical Features:

1. Excessive outward curvature of the thoracic spine.
2. Rounded upper back (hunchback appearance).
3. Forward head posture.
4. Rounded and drooping shoulders.
5. Scapular protraction (shoulder blades move forward).
6. Upper back pain and stiffness.
7. Tight chest (pectoral) muscles.
8. Weak upper back extensor muscles.
9. Reduced spinal mobility.
10. Decreased chest expansion.
11. Difficulty maintaining an upright posture.
12. In severe cases, breathing difficulty due to reduced lung expansion. Fatigue with prolonged sitting or standing.
13. In advanced cases, balance problems and impaired functional activities.

Types of Lordosis

1. Postural Lordosis – Caused by poor posture, obesity, or weak abdominal muscles.
2. Congenital Lordosis – Present at birth due to abnormal spinal development.
3. Traumatic Lordosis – Develops after injury or trauma to the spine.
4. Neuromuscular Lordosis – Associated with neuromuscular disorders such as cerebral palsy or muscular dystrophy.
5. Secondary (Compensatory) Lordosis – Occurs as compensation for other spinal conditions, such as kyphosis or hip disorders.

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