SOUTH

KAZAKHSTAN
MEDICAL
ACADEMY
DEPARTMENT OF ANATOMY
Topic : Physiological and pathological curvatures of
vertebral column
PREPARED BY : MOHD SHAHBAZ SHARIEF
GROUP NO. : 04 - A - 22
SUBMITTED TO : TAGAY AKNIYET BEKZHIGITULY
 Contents
• Physiological and pathological curvatures of the
vertebral column
• Causes, mechanisms of development and methods of
treatment of pathological curvatures.
• Types of postures.
 Physiological curvatures of the vertebral
column
• Vertebral column : The adult vertebral column consists of 24
vertebrae, plus the sacrum and coccyx. The vertebrae are divided into
three regions: cervical C1–C7 vertebrae, thoracic T1–T12 vertebrae,
and lumbar L1–L5 vertebrae. The vertebral column is curved, with
two primary curvatures (thoracic and sacrococcygeal curves) and two
secondary curvatures (cervical and lumbar curves).

• Curvatures of the Vertebral Column

• The adult vertebral column does not form a straight line, but instead
has four curvatures along its length. These curves increase the
vertebral column’s strength, flexibility, and ability to absorb shock.
 Primary curvatures
• During fetal development, the body is flexed anteriorly into the
fetal position, giving the entire vertebral column a single
curvature that is concave anteriorly. In the adult, this fetal
curvature is retained in two regions of the vertebral column as
the thoracic curve, which involves the thoracic vertebrae, and
the sacrococcygeal curve, formed by the sacrum and coccyx.
Each of these is thus called a primary curve because they are
retained from the original fetal curvature of the vertebral
column.
 Secondary curvatures
• A secondary curve develops gradually after birth as the child
learns to sit upright, stand, and walk. Secondary curves are
concave posteriorly, opposite in direction to the original fetal
curvature. The cervical curve of the neck region develops as
the infant begins to hold their head upright when sitting. Later,
as the child begins to stand and then to walk, the lumbar
curve of the lower back develops. In adults, the lumbar curve is
generally deeper in females.
Pathological curvatures of the vertebral
column
• There are three main types of spine curvature disorders, including:
1. Lordosis :  Also called swayback, the spine of a person with
lordosis curves significantly inward at the lower back.  Lordosis can
affect your lower back and neck. This can lead to excess pressure on
the spine, causing pain and discomfort. It can affect your ability to
move if it’s severe and left untreated.
 • Causes Of LORDOSIS
• Spondylolisthesis: Spondylolisthesis is a spinal condition in
which one of the lower vertebras slips forward onto the bone
below. It’s usually treated with therapy or surgery.
• Achondroplasia: Achondroplasia is one of the most common
types of dwarfism.
• Osteoporosis: Osteoporosis is a bone disease that causes a
loss of bone density, which increases your risk of fractures.
• Osteosarcoma: Osteosarcoma is a bone cancer that typically
develops in the shinbone near the knee, the thighbone near the
knee, or the upper arm bone near the shoulder. 
• Obesity: This condition puts people at a higher risk for serious
diseases, such as type 2 diabetes, heart disease, and cancer. 
Mechanism of development of lordosis
• In the situation of lumbar lordosis, abdominal muscles are weaker
than the muscles in the lumbar spine and the hamstring muscles.
The muscular imbalance results in pulling down the pelvis in the
front of the body, creating a swayback in the spine.
• Lordosis develops if your spine curves too much and pushes your
posture out of its usual alignment. You might see lordosis that affects
your lumbar spine called swayback. Remember, lordosis is normal in
the cervical and lumbar spine. In the cervical spine, a 30- to 40-
degree curve is normal.
Treatment of Lordosis
Most people with lordosis don’t require medical treatment unless
it’s a severe case. Treatment for lordosis will depend on how
severe your curve is and the presence of other symptoms.
Treatment options include:
• medication, to reduce pain and swelling
• daily physical therapy, to strengthen muscles and range of
motion
• weight loss, to help posture
• braces, in children and teens
• surgery, in severe cases with neurological concerns
• nutritional supplements such as vitamin D.
2. Kyphosis : Kyphosis is
characterized by an abnormally
rounded upper back (more than
50 degrees of curvature).
• An increased front-to-back
curve of the spine is called
kyphosis. Kyphosis is an
exaggerated, forward rounding
of the upper back. In older
people, kyphosis is often due
to weakness in the spinal
bones that causes them to
compress or crack.
Causes of KYPHOSIS
• The cause of kyphosis depends on the type:
• Postural: Poor posture, leaning back in chairs, carrying
heavy bags.
• Scheuermann’s: Problem in your spine’s structure.
• Congenital: Issue developed in your spine before birth.
• Other causes of kyphosis include:
• Age, as your spine starts to curve more as people get
older.
• Spinal injury.
Mechanism of development of KYPHOSIS
• Kyphosis occurs when the vertebrae in the back become more
wedge shaped. The shape of vertebrae can be changed by:
Fractures. Broken vertebrae can result in curvature of the
spine.
 Treatment of KYPHOSIS
• Treatment options include:
• Monitoring the curve: Regular X-rays during the teenage
years keep tabs on the curve’s progress.
• Physical therapy: Exercises can strengthen abdominal and
back muscles to relieve pain and improve posture. Other
exercises can stretch tight hamstrings and strengthen other
areas of your body.
• Pain medication: Anti-inflammatory medicines can relieve
back pain.
• Back brace: Your provider may recommend a brace in rare
cases. It’s most common when children who are still growing
have Scheuermann’s kyphosis.
3. Scoliosis : A person with scoliosis has a sideways curve
to their spine. The curve is often S-shaped or C-shaped.
• In some, the degree of curve is stable, while in others, it
increases over time. Mild scoliosis does not typically cause
problems, but more severe cases can affect breathing and
movement. Pain is usually present in adults, and can worsen
with age.
Causes of SCOLIOSIS
• In most cases, the cause of scoliosis is idiopathic (unknown).
Researchers continue to study possible causes for idiopathic
scoliosis and think that a combination of several factors may
lead to the disorder. These include:
• Genes.
• Hormones.
• Changes in cell structure.
Treatment of SCOLIOSIS
• Scoliosis treatments vary, depending on the severity of the curve.
Children who have very mild curves usually don't need any treatment
at all, although they may need regular checkups to see if the curve is
worsening as they grow.
• Bracing or surgery may be needed if the spinal curve is moderate or
severe. Factors to be considered include:
• Maturity. If a child's bones have stopped growing, the risk of curve
progression is low. That also means that braces have the most effect in
children whose bones are still growing.
• Severity of curve. Larger curves are more likely to worsen with
time.
• Sex. Girls have a much higher risk of progression than do boys.
 Types of Postures
• Posture is the position of your body when you’re standing or
sitting. It describes how your spine is aligned with your head,
shoulders, and hips.
• Lordotic posture : Lordosis refers to the normal inward
curvature of the spine. When this curve is exaggerated it is
usually referred to as Hyperlordosis. The pelvis is usually tilted
anteriorly.
• Sway Back Posture : In this type of posture, there is forward
head, hyper-extension of the cervical spine, flexion of the
thoracic spine, lumbar spine extension, posterior tilt of the
pelvis, hip and knee hyper-extension and ankle slightly
plantarflexed.
• Flat back posture : In this type of posture, there is forward
head, extension of the cervical spine, extension of the thoracic
spine, loss of lumbar lordosis and posterior pelvic tilt.
• Forward head posture : Describes the shift of the head
forward with the chin poking out. It is caused by increased
flexion of the lower cervical spine and upper thoracic spine with
increased extension of the upper cervical spine and extension of
the occiput on C1.
• Scoliosis : A deviation of the normal vertical line of the spine,
consisting of a lateral curvature and rotation of the vertebrae.
Scoliosis is considered when there is at least 10° of spinal
angulation on the posterior-anterior radiograph associated with
vertebral rotation. This is a 3 dimensional C or S shaped
sideways curve of the spine.
• Kyphosis : An increased convex curve observed in the thoracic
or sacral regions of the spine.