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Loss of Cervical Lordosis

As a practicing Orthopaedic Spine Surgeon,  I often get back x-ray reports indicating “Loss of Cervical Lordosis”.   As most of my patients are highly educated,  they often will read that report, and will come to discuss the finding.  So,  I thought I would share my comments on the topic.

As some of you may know,  Lordosis is the curvature of the spine in the sagittal plane  ( simply stated,  the side view),  by which the front portion of the curve points to the front of the body.    Humans typically have  four curves when viewing the spine from the side.  Going from the head,  the first curve is a lordosis curve from the skull to the lower neck.  Then,  there is a compensatory curvature in the opposite direction (kyphosis) from the lower neck to the upper back.  Then,  there is another Lordosis curve from the upper back to the lower back.  Finally,  in the tailbone,  there is a reverse curve (kyphosis).  When you measure the effects of the four curves when standing,  in general,  you have a situation where the head is then balanced over the pelvis, and the center of gravity of a normal person will be positioned  directly in the center of the body.  With that effect,  when standing straight up,  your body will be balanced over the center of gravity,  and there will not be the forces pulling you, or pushing you in any direction.

But,  when we have irritations of parts of the spine,  it can cause this natural gentle curve to straighten.  Often times,  when people have irritation to the neck muscles,  an x-ray or MRI can show loss of the normal lordosis.

For most normal humans,  without any degeneration of the disks,  fractures,  or symptomatic disk herniations,  these muscle irritations do improve and usually,  the lordosis does return.

But,  if we have progressive disk degeneration, or a break,  or arthritis,  the lordosis may decrease, or reverse permanently over time.

So,  when I review an MRI or x-ray, and I see reversal of lordosis,  it does not necessarily mean it is a new finding.  If the advanced degenerative findings are present,  loss of lordosis is expected.

Other factors to consider when discussing Lordosis,  especially in patients without significant pain,  is a positional nature of loss of lordosis.  X-rays and MRI’s can be taken when lying down.  In that scenario,  the position of the neck can cause the image to look like a loss or reversal of lordosis.

Also,  in relationship to the lumbar spine,  sitting MRI’s often will show a loss of lordosis.

In summary,  loss of lordosis can and usually is associated with irritation of the muscles causing loss of the normal curvature.  Muscle irritations can be caused by disk herniations,  muscle sprains, and fractures.  But,  true structural  permanent loss of lordosis is usually secondary to advanced degeneration,  or structural changes to the bones, and disks of the spine.  In rare instances,  humans can be born with a loss of lordosis.

 

 

Last modified: January 24, 2018

6 thoughts on “Loss of Cervical Lordosis

    1. Please read the blog. Basically a loss of cervical lordosis can be from muscle spasm, injury or can be normal for that person.

  1. My father has been operated on c1 c2 2 times in Indore, Madhya Pradesh India, but after the operation, he is very pained and dizzy and has a tingling, burning sensation in his arms and legs is also very painful and the pain is terrible It is difficult to sleep

  2. This loss of the cervical lordosis is something my chiropractor has told me exists in my spine. I actually am curved in the opposite direction. The pain and spasms in my neck have become almost unbearable. I have been to pain management but I need to know if anything can be done to reverse this. What do you do in your clinic for this problem? I live in Winter Haven, about an hour outside of Tampa, and I would like some answers before I make that drive. I am 67 and have Medicare and Cigna for my secondary insurance, do you take these. I also just had a new MRI last week. I can pick up the disc & report anytime.
    Thank you.
    Linda

    1. Good morning Linda. We are not contracted with Medicare or any secondary insurances. Most often the reversal of lordosis is caused by spasm so you would need to find out what is causing that. Please feel free to call us for an appointment if you are able to see us. We charge a fee for an hour of Dr. Shim’s time. He examines you, reviews all films and goes over your options. I hope you can see us. For any questions, please call the office and ask for me. 813-814-9251.
      Cathie

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