Lordosis refers to the inward curve of the lumbar spine (just above the buttocks). A small degree of lordosis is normal. Too much lordotic curving is called swayback (lordosis).
Swayback; Arched back
Lordosis tends to make the buttocks appear more prominent. Children with significant lordosis will have a large space underneath the lower back when lying face up on a hard surface.
Some children have more pronounce lordosis, which most often fixes itself as the child grows. This is called benign juvenile lordosis.
Spondylolisthesis may cause lordosis.
It is a condition in which a bone (vertebra) in the spine slips out of the proper position onto the bone below it.
You may be born with this, it can develop after certain sports activities, such as gymnastics, or it may develop along with arthritis in the spine.
Much less common causes in children include:
Achondroplasia, a disorder of bone growth that causes the most common type of dwarfism
Other genetic conditions
Most of the time, lordosis is not treated if the back is flexible. It is not likely to progress or cause problems.
When to Contact a Medical Professional
Call your health care provider if you notice that your child has an exaggerated posture or a curve in the back. The condition should be checked by a doctor to see if there is a medical problem.
What to Expect at Your Office Visit
The health care provider will perform a physical exam. The child may be asked to bend forward, to the side, and to lie flat on a table so that the spine can be examined in a variety of positions. If the lordotic curve is flexible (when the child bends forward the curve reverses itself), it is generally not a concern. If the curve does not move, medical evaluation and treatment are needed.
Other tests may be needed, particularly if the curve seems "fixed" (not bendable). These may include:
Other tests to rule out disorders that could be causing the condition
MRI of the spine
Spiegel DA, Dormans JP. The spine. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 671.
C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.