Swayback; Arched back; Lordosis - lumbar
Lordosis is the inward curve of the lumbar spine (just above the buttocks). A small degree of lordosis is normal. Too much curving is called swayback.
Lordosis tends to make the buttocks appear more prominent. Children with hyperlordosis will have a large space underneath the lower back when lying face up on a hard surface.
Some children have marked lordosis, but, most often fixes itself as the child grows. This is called benign juvenile lordosis.
Spondylolisthesis may cause lordosis. In this condition, 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. It may develop along with arthritis in the spine.
Much less common causes in children include:
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. Your provider must check to see if there is a medical problem.
What to Expect at Your Office Visit
The provider will do a physical exam. To examine the spine, your child may have to bend forward, to the side, and to lie flat on a table. 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:
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Safain MG, Hwang SW, Samdani AF. Introduction to spinal deformities in children. In: Winn HR, ed. Youmans and Winn Neurological Surgery. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 237.
Warner WC, Sawyer JR. Scoliosis and kyphosis. In: Azar FM, Beaty JH, Canale ST, eds. Campbell's Operative Orthopaedics. 13th ed. Philadelphia, PA: Elsevier; 2017:chap 44.