Expert: Dr. J. Shawn Leatherman - 12/2/2008

Question
I received xray results stating that I have a loss of normal lordotic curvature in teh lumbar spine and there is an absence of posterior arch of c1 in teh cervical spine. Can you explain this in laymen's terms?  Advice greatly appreciated.

Answer
Dear Anita,

The optimal lordotic curve in the lumbar spine measures 40 degrees. So if your curve is within 5 degrees in either direction I would consider this normal structure. If the curve is reduced the actual value of the curve will drop, and if the measured value drops to 30 degrees or less, I would consider this abnormal.  However, this must also be qualified in addition to the angulation of the sacrum (bone the spine sits on) as well as the angulation of the pelvic incidence.  **Spinal degrees for all of the curves in the spine have been researched and published in the scientific literature... specifically the journal SPINE has published these values.**

Sounds complicated huh...well is isn't really...we have normative data where the majority of the population falls that do not have back pain issues, and this has been computed to find the normal lordosis angle of the lumbar spine.  That data also includes people with acute and chronic back pain and shows that loss of the lordosis is highly correlated with degeneration and increasing pain levels.

So what does this mean...as the spine loses its normal configuration, the spinal cord and exiting nerve roots are stretched and stressed.  The disk material and the cartilage that lines the joint spaced is under increased stress and compression.  This can all cause inflammation, poor function, pain, and degeneration.  

Now, I do not know what type of doctor gave you these results, but if you would like a more in depth explanation, I would recommend that you look at www.idealspine.com and find a doctor who has completed advanced training on structural analysis and rehabilitation.  They have a physician locator on the websites (left hand side of homepage)so you can find someone close to your location.

Concerning the absence of the posterior arch, this is usually just an incidental finding and really doesn't mean a whole lot concerning pain, dysfunction, or treatment.  This is a form of Spinal bifida occulta (neural tube defect) and can be classified as a congenital anomaly. This may also be termed "spondyloschisis" Basically this has been linked to folate deficiency of the mother while you were developing in utero.  I wouldn't worry too much about it.

Hope this helps Anita.

Respectfully,
Dr. J. Shawn Leatherman
www.suncoasthealthcare.net