Lordosis refers to the natural inward curves of the human spine. These curves help the spine absorb shock, maintain balance, and support the body’s weight during movement. While a certain degree of lordosis is healthy, an excessive or flattened curve can indicate a medical condition. An X-ray is a common diagnostic tool used to assess these spinal curves.
Understanding Lordosis
Lordosis describes the natural inward curvature of the spine. Everyone possesses a degree of this inward curve in their lower back and neck, which is considered normal and beneficial for spinal function. A typical lumbar spine curve ranges from 40 to 60 degrees, while the cervical spine has a curve between 20 and 40 degrees.
Problems arise when the spinal curve becomes either excessively pronounced, known as hyperlordosis or “swayback,” or when it flattens out, termed hypolordosis or “flatback.” Hyperlordosis often makes the stomach and buttocks appear more prominent and can lead to lower back pain, muscle tightness, or posture issues. Conversely, hypolordosis signifies a reduction or loss of this natural inward curve. Both conditions can impact spinal health and may require medical attention.
The Role of X-Rays in Diagnosis
X-rays serve as a primary diagnostic tool for assessing lordosis because they effectively visualize bone structures and spinal alignment. This imaging technique uses electromagnetic waves to create detailed pictures of the bones in the neck and back. These images clearly show the vertebrae, appearing white, while soft tissues like muscle and fat appear in shades of gray.
A lordosis X-ray involves taking images from various angles, such as lateral (side) views and sometimes anterior-posterior (front-to-back) or posterior-anterior (back-to-front) views. Patients stand during these X-rays to capture the spine under normal weight-bearing conditions. Little preparation is needed, though patients may be asked to remove any metal objects or jewelry that could interfere with the images.
What an X-Ray Reveals About Lordosis
An X-ray provides specific, measurable information about the spinal curve. The degree of lordosis is commonly quantified using the Cobb angle method. This involves drawing lines parallel to the endplates of specific vertebrae at the extreme ends of the curve, and then measuring the angle formed by their intersection or by perpendicular lines drawn from them. For cervical lordosis, the angle is measured between the inferior endplate of C2 and the inferior endplate of C7. For lumbar lordosis, it is measured from the upper endplate of L1 to the upper endplate of S1.
These measurements help determine if the lordosis falls within a typical range, is excessive, or is reduced. An X-ray can also identify the precise location and severity of any abnormal curves. Beyond just the curve, X-rays can reveal associated spinal issues like vertebral abnormalities, degenerative changes such as bone spurs, or other alignment problems that might contribute to or result from lordosis. They can also detect fractures, osteoporosis, or arthritis that may affect spinal alignment.
Interpreting Your X-Ray Results
X-ray images are initially reviewed and interpreted by a radiologist, a medical doctor specializing in interpreting medical images. The radiologist then compiles a report detailing their findings, which is sent to the healthcare provider who ordered the exam. This report will often include measurements like the Cobb angle, indicating the degree of your spinal curve.
A specific Cobb angle measurement might suggest mild, moderate, or severe lordosis, or indicate a straightened curve. However, these numerical findings are just one piece of the diagnostic puzzle. The treating physician combines the X-ray results with a patient’s reported symptoms, medical history, and findings from a physical examination to form a comprehensive diagnosis. This integrated approach allows for a complete understanding of the spinal condition and informs any subsequent medical decisions.