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PubMed2002

A new 3-point bending traction method for restoring cervical lordosis and cervical manipulation: a nonrandomized clinical controlled trial.

OBJECTIVE: To evaluate a new 3-point bending type of cervical traction. DESIGN: Nonrandomized controlled trial of prospective, consecutive patients compared with control subjects. Follow-up patient data were obtained at 3 and 15(1/2) months, and 8 1/10 months for controls. SETTING: Data were collected at a spine clinic in Nevada. PATIENTS: Volunteer subjects consisted of 30 patients and 24 controls. Subjects had cervicogenic pain (neck pain, headaches, arm pain, and/or numbness). Subjects were included if their Ruth Jackson radiographic stress lines measured less than 25 degrees but were excluded if they had suspected disk herniation or canal stenosis. All subjects completed the first follow-up examinations, and 25 of 30 patients completed the long-term follow-up examination. INTERVENTIONS: Spinal manipulation for pain and a new form of 3-point bending cervical traction to improve lordosis. Cervical manipulation was provided for the first 3 to 4 weeks of treatment. Traction treatment consisted of 3 to 5 sessions per week for 9 +/- 1 weeks. MAIN OUTCOMES MEASURES: Besides pain visual analog scale (VAS) ratings, pre- and posttreatment lateral cervical radiographs were analyzed. RESULTS: Control subjects reported no change in the pain VAS ratings and had no statistically significant change in segmental or global radiographic alignment. For the traction group, VAS ratings were 4.3 pretreatment and 1.6 posttreatment. Traction group radiographic measurements showed statistically significant improvements (P <.008 in all instances of statistical significance), including anterior head weight bearing (improved 6.2mm), Cobb angle at C2-7 (improved 12.1 degrees ), and angle between posterior tangents at C2-7 (improved 14.2 degrees ). For the treatment group, at 15(1/2)-month follow-up, only minimal loss of C2-7 lordosis (3.5 degrees ) was observed. CONCLUSIONS: Sagittal cervical traction with transverse load at midneck (2-way cervical traction) combined with cervical manipulation can improve cervical lordosis in 8 to 10 weeks as indicated by increases in segmental and global cervical alignment. Magnitude of lordosis at C2-7 remained stable at long-term follow-up.

Adult↗
PubMed2004

The membrane actions of estrogens can potentiate their lordosis behavior-facilitating genomic actions.

The membrane actions of estrogens can facilitate their genomic actions. To determine whether this facilitation bears on CNS mechanisms for estrogen-dependent behaviors, ovariectomized rats were subjected to a two-pulse treatment of estrogen directly in the hypothalamic ventromedial nucleus. Two days later, each rat was given progesterone and then tested for lordosis behavior, the induction of which requires the genomic actions of estrogen. When estrogen was given in both pulses (15 min to 2 h duration, and 5 h apart) lordosis was induced. Based on results from studies on neuroblastoma cells, we hypothesized that the membrane actions of estrogen in the first pulse would potentiate the genomic actions of estrogen in the second. This hypothesis was confirmed with the use of a membrane-impermeable estrogen. However, surprisingly, the order of the pulses could be reversed and still achieve lordosis behavior induction. Finally, activators of protein kinase A or PKC were effective substitutes for the membrane-limited pulse of estrogen. Thus, estrogen-induced membrane actions in the hypothalamus can potentiate its lordosis-inducing genomic actions on behavior and may be mediated by signaling pathways involving the activation of protein kinase A and PKC.

Animals↗
PubMed2003

Relationship between cervical lordosis and facial morphology in Caucasian women with a skeletal class II malocclusion: a cross-sectional study.

Several published studies show a relationship between craniofacial morphology and head posture. The aim of this study was to evaluate the association between cervical lordosis angle and mandibular length from lateral skull radiographs, and to investigate the relationship between mandibular retrusion and cervical lordosis angle decreasing. The sample comprised 70 Caucasian adult women, average 27.4, in skeletal class II and Angle class II. Lateral skull radiographs were obtained in natural head position (mirror position). Ten morphological variables were individuated on tracings. In order to assess errors due to landmark identification, double measurements were made in ten randomly selected radiographs and were compared with Dahlberg's formula. A Sperman's rank correlation test showed a negative correlation (P < 0.01) between cervical lordosis and mandibular length (compensatory curvature of the cervical spine) and positive correlation between anterior cranial base and maxillary length (P < 0.05). Based upon the cross-sectional method, no conclusion was possible about the mechanism concerning these results. Future longitudinal studies in growing patients should be directed to understanding the extent of environmental and genotype influences on cervical lordosis angle.

Adult↗
PubMed1992

5,7-DHT facilitated lordosis: effects of 5-HT agonists.

The role of 5-HT (serotonin) in regulating lordosis was investigated by combining peripheral administration of the 5-HT agonists 8-OH-DPAT (8-hydroxy-2-[di-N-propylamino]tetralin) or TFMPP (1-[m-trifluoromethylphenyl]piperazine), with intrahypothalamic application of the 5-HT neurotoxin 5,7-DHT (5,7-dihydroxytryptamine). The 5-HT1A agonist, 8-OH-DPAT, significantly inhibited lordosis in 5,7-DHT-treated and non-treated rats. TFMPP, an agonist at 5-HT1B and 5-HT1C receptors, significantly facilitated lordosis in 5,7-DHT-treated and non-treated rats. Our results show that both inhibitory and facilitatory influences of hypothalamic 5-HT on lordosis, are modulated via postsynaptic receptors.

5,7-Dihydroxytryptamine↗
PubMedDate not supplied

Gait abnormalities arising from latrogenic loss of lumbar lordosis secondary to Harrington instrumentation in lumbar fractures.

Six patients with lumbar fractures were studied at the Pathokinesiology laboratory at Rancho Los Amigos Hospital following posterior Harrington distraction instrumentation to identify changes in posture and gait associated with iatrogenic loss of lumbar lordosis. Three patients, all with painful rods, were treated with standard Harrington instrumentation and full length fusion. Three patients were treated with so-called "rodded long-fused short" procedures. It was thought that rod removal in the latter group would result in restoration of lumbar lordosis with concomitant improvement in posture and gait when compared to the full length fusion group. No significant difference between the two groups was found. Rod removal often resulted in kyphotic collapse at the previous fracture site despite solid posterior arthrodesis with net decrease in lumbar lordosis. Hip hyperextension, when available, was the favored compensatory mechanism for loss of lumbar lordosis. Otherwise, hip flexion and forward lean of the trunk was seen.

Adult↗
PubMed1992

The influence of lordosis on axial trunk torque and trunk muscle myoelectric activity.

Force contributions from the facet complex and posterior ligaments during the generation of axial torque are a function of lordosis, and it has been speculated that these forces together with muscular contributions play a role in axial trunk twisting. This study investigated the electromyographic activity of the trunk musculature and torque-generating capacity of the lumbar spine under the conditions of normal lordosis, hyperlordosis, and hypolordosis. Eleven male subjects volunteered for this study. The subjects performed isometric twisting efforts and maximum dynamic twisting efforts at 30 degrees/sec. The myoelectric activity levels (normalized to maximal amplitude obtained from nontwist activities) were quite low despite maximal efforts to generate axial torque (for example: approximately 60% maximum voluntary contraction for latissimus dorsi and even lower for the abdominals). Furthermore, changes in lordosis did not produce any consistent changes in muscle activity, although a hyperlordotic spine produced significantly smaller axial torques, and a hypolordotic spine smaller still. Larger torques were measured during all three conditions of lordosis, as the subjects rotated toward an untwisted position, and lower torques as the subjects rotated away. The opposite trend was observed, however, in myoelectric activity of the agonistic side of latissimus dorsi, the thoracic level of erector spine, and the lumbar level of erector spinae, i.e., larger amplitudes were observed as the trunk was twisted away from the untwisted position. These data suggest that tissues other than muscle (i.e., passive tissue) contribute significantly to axial torque production and that the flexed and twisted spine is less able to resist applied axial torques, possibly increasing the risk of torsional injury.

Abdominal Muscles↗
PubMed1996

Growth of the cervical spine with special reference to its lordosis and mobility.

STUDY DESIGN: The cervical spine of the healthy Japanese children aged between 1 year and 18 years was radiographically examined. OBJECTIVES: To examine the correlation between growth of the cervical vertebral body and the facet joint and the development of the cervical lordosis and intervertebral motion. SUMMARY OF BACKGROUND DATA: Although the growth of body height and facet angle have been well documented, their correlation with curvature or mobility has not been elucidated. METHODS: We evaluated plain lateral radiographs of 180 boys and 180 girls regarding diameters and central heights of the cervical vertebra, the anterior and posterior vertebral height ratio, body height index, the facet joint angles, and tilting and sliding motions. Cervical length as the summation of the central height from C3 to C7 and the cervical lordosis angle (C3-C7 angle) were also measured. RESULTS: The mean C3-C7 angle and body height index gradually decreased until 9 years of age and then increased. The C3-C7 angle showed a significant correlation with cervical length, body height index, and facet joint angles before 9 years of age, and with cervical length and body height index after 9 years of age but not with facet joint angles. Facet joint angle decreased until 10 years of age and remained almost unchanged thereafter. Total sliding showed a significant age-related decrease and showed a significant correlation with facet joint angle. CONCLUSION: Although the lordosis angle showed a significant correlation with the other values, cervical length, body height index, and facet joint angle, the determinants of the lordosis could not be elucidate in the present study. As for the mobility of the cervical spine, changes of tilting motion were small, whereas changes of sliding motion were restricted by the change of orientation of the facet joints.

Adolescent↗
PubMed2004

Good outcome and restoration of lordosis after anterior lumbar interbody fusion with additional posterior fixation.

STUDY DESIGN: Fifty-two patients with degenerative disc disease underwent single- or double-level anterior lumbar interbody fusion with SynCage and additional posterior fixation as treatment for degenerative disc disease and were prospectively followed for 4 years. OBJECTIVES: To test the clinical performance of anterior lumbar interbody fusion with SynCage, with emphasis on the safety and efficacy of the surgical procedure and the ability to restore anatomy and fuse the motion segment. SUMMARY OF BACKGROUND DATA: Anterior lumbar interbody fusion using femoral allograft and/or autologous bone has a high complication rate. With cage technology, some of these complications can be avoided. The design characteristics of the SynCage offer advantages in restoring and maintaining intervertebral height and restoration of lumbar lordosis. METHODS: Thirty-three patients underwent single-level and 19 patients double-level anterior lumbar interbody fusion with SynCage and additional posterior fixation (translaminar screws, n = 32 or pedicle screws, n = 10). Radiologic and functional results (VAS and Oswestry score) were evaluated. RESULTS: Intervertebral height was corrected from an average of 8.7 to 17.6 mm. Lordosis of the fused segment was significantly increased (average 10.6 degrees for the fused segment and 8 degrees for lumbosacral lordosis). After 2 years, there was radiologic evidence for fusion in 70 of 71 (98.6%) levels. Functional scores showed a significant improvement in pain and function up to the 2-year follow-up observation. At the 4-year follow-up observation, there was some loss of the initial improvement in VAS and Oswestry scores. Despite this loss, they remained significantly better than the preoperative scores. CONCLUSIONS: Anterior lumbar interbody fusion with SynCage and additional posterior fixation is a safe and effective procedure. Intervertebral height is corrected, and lumbosacral lordosis is restored. An initial improvement in VAS and Oswestry scores is partly lost at the 4-year follow-up observation, but 4-year results are still significantly better than the preoperative scores.

Adult↗
PubMed1980

Responses of lumbosacral spinal units to mechanical stimuli related to analysis of lordosis reflex in female rats.

1. To analyze further the sensory mechanisms for triggering the lordosis reflex, single-unit (n = 345) activity was recorded extracellularly from spinal segments L5-S1 of urethan-anesthetized female rats. Unit responses to pressure on the skin (necessary and sufficient for evoking lordosis) and other mechanical stimuli were studied. 2. Units were classified according to their responses to the battery of mechanical stimuli: 16% of the units responded only to pressure. The majority of these pressure-responsive units were excited, while a few were inhibited or responded differently, depending on the site stimulated; 52% did not respond to pressure, but responded to brushing, muscle-joint, and/or visceral stimulation, or did not respond at all. The remaining 32% responded to pressure plus other forms of stimulation. 3. Units responding only to the movement of individual types of hair tended to be located in the dorsal horn, more dorsal than units responding only to pressure (found primarily in the intermediate gray). Units responding to subdermal stimulation were usually found at greater depths. Segmental and somatotopic distributions of spinal units observed were very similar to those reported for cat (3) and monkey (5). 4. Compared to primary sensory units (28), spinal units had higher resting firing rates, more complicated responses to a given stimulus, a wider variety of unit types, and much larger receptive fields. These comparisons tend to indicate convergence of primary sensory neurons onto individual spinal units. 5. The range of pressure thresholds of pressure-responsive units is comparable to the range effective for triggering lordosis. We postulate that excitation of units responding only to pressure is centrally involved in triggering the lordosis reflex. Those units not responding to pressure are probably irrelevant for this behavior. Presently undetermined are the roles of units with complex or mixed-response types.

Animals↗
PubMed1987

Facilitation of lordosis by injection of substance P into the midbrain central gray.

Behavioral experiments tested the idea that the substance P (SP) innervation of the midbrain central gray (MCG) may be involved in the hormonal induction of sexual receptivity in female rats. SP, a SP antiserum or a reported SP antagonist were injected bilaterally into the MCG in ovariectomized, estrogen-treated females, and the lordosis response was recorded at repeated intervals. In the first experiment, three doses of SP (50,500 and 1,000 ng/cannula), a single dose of LHRH (50 ng/cannula) or vehicle were given to separate groups of females. All three doses of SP produced a rapid and long-lasting (3 h) increase in lordosis scores in moderately receptive females in tests with either manual stimulation or male rats. This facilitation was similar in latency, magnitude and duration to that produced by LHRH. In the second experiment, the basic findings of experiment 1 were replicated using blind testing. As no dose-response relation was established in experiment 1, a lower dose of SP (10 ng/cannula) was used in addition to doses of 50 and 500 ng/cannula also used in experiment 1. All three doses produced similar long-lasting increases in lordosis scores as in experiment 1. MCG injections of SP also increased lordosis scores in a second series of tests using manual stimulation alone. This demonstrates that the SP-induced facilitation does not depend on an interaction between the injections and stimuli delivered only by the male rat, eg., vaginal stimuli or ultrasonic calls. The question of the importance of endogenous SP for receptivity was examined in experiment 2 using MCG injections of a SP antiserum or the SP analogue, (D-Pro2, D-Trp7,9)-SP, which has been reported to block the excitation of locus coeruleus neurons by SP.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed2006

Facilitation of lordosis in rats by a metabolite of luteinizing hormone releasing hormone.

In the female rat, ovulation is preceded by a marked increase in the release of the decapeptide, LHRH, culminating in a preovulatory LH surge, which coincides with a period of sexual receptivity. The decapeptide, LHRH, is processed by a zinc metalloendopeptidase EC 3.4.24.15 (EP24.15) that cleaves the hormone at the Tyr(5)-Gly(6) bond. We have previously reported that the autoregulation of LHRH gene expression can also be mediated by its metabolite, LHRH-(1-5). Given the central function of LHRH in reproduction and reproductive behavior, we examined the role of the metabolite, LHRH-(1-5), in mediation of LHRH-facilitated reproductive behavior. Intracerebroventricular administration of LHRH-(1-5) facilitated sexual behavior responses, similar to those facilitated by the decapeptide LHRH, in ovariectomized estradiol-primed female rats. Furthermore, immunoneutralization of EP24.15 resulted in the inhibition of the LHRH-facilitated lordosis but had no inhibitory effects on LHRH-(1-5)-facilitated lordosis. The LHRH antagonist, Antide, was capable of inhibiting LHRH-facilitated lordosis, without affecting LHRH-(1-5)-facilitated lordosis. Collectively, these results suggest a role for LHRH metabolites in the facilitation of female receptive behavior in rats.

Analysis of Variance↗
PubMed2005

Effects of 5-HT1A-receptor agonist, 8-OH-DPAT, and GABAB-receptor agonist, baclofen, on lordosis in female rats with lesions in either the dorsal raphe nucleus or septum.

The inhibitory effects of 8-OH-DPAT, a 5-HT1A-receptor agonist, and baclofen, a GABAB-receptor agonist, on lordosis were examined in estrogen and progesterone-treated ovariectomized rats with lesions in either the dorsal raphe nucleus (DRN) or septum and in rats with either sham lesions or no lesions. The first behavior test series was carried out 6 days after implantation of the rats with silicon tubes containing estradiol. Four hours after injection with 0.5 mg progesterone, behavioral tests were performed before and 30 min after an injection with 1 mg/kg body weight 8-OH-DPAT. As a result, the mean lordosis quotient (LQ)s were changed from 100 to less than 20 before and after the injection in all groups. These results suggest that 8-OH-DPAT acts on areas other than the DRN and the septum, leading to a decrease in lordosis. Two weeks after implantation with estradiol, the next behavioral test series was carried out after injection with progesterone. Behavioral tests were performed before and after an injection with 10 mg baclofen. The results showed that the mean LQs decreased after the injection in all groups, but the mean LQ in the DRN lesion group was higher than that in the sham groups. These results indicate that baclofen may act partially on the DRN in inhibiting lordosis in female rats.

8-Hydroxy-2-(di-n-propylamino)tetralin↗
PubMed1976

Heterotypical sexual behavior in male rats: individual difference in lordosis respones.

Castrated Wistar male rats were primed with varying amounts of estradiol benzoate (EB) for successive 2 days and progesterone (P) on the third day 6-8 hr prior to the behavioral test. The tests were performed 4 times at 2-3 weeks intervals. As a priming procedure for the first behavioral test, 50 mug EB and 0.5 mg P were given. The quantity of P was kept constant therafter. For the second test, the dose of EB was increased to 100 mug, but decreased again to 50 mug and further to 10 mug for the third and fourth tests, respectively. The inciedence of animals showing lordosis was quite low, and was not significantly changed by increasing or decreasing the dosage of EB during the series of the behavioral tests. Forty-three out of 51 animals never showed lordosis at all 4 behavioral tests. In contrast, 5 out of 8 rats which responded to mountings by the males continued to display lordosis behavior throughout the series of the successive 4 tests. This consistence of individual responeses during the series of the behavioral tests may indicate the possible existence of individual difference in lordosis responde in male rats.

Animals↗
PubMed1982

Forebrain lordosis inhibiting system and serotonin neuron in female rats: effect of P-chloroamphetamine.

Relationship between forebrain lordosis inhibiting system and serotonergic mechanism was examined in estradiol benzoate (EB) and progesterone (P)-primed ovariectomized rats. In order to remove the forebrain inhibition of lordosis response, anterior roof deafferentation (ARD) which interrupts the dorsal inputs to the POA coming down anterior to the anterior commissure or medial preoptic area lesions (POA-L) were made. All experimental females pretreated with EB and P showed high levels of lordotic activity. Soon after the behavioral tests, the animals were injected with 10 mg/kg p-chloroamphetamine (PCA) intraperitoneally and tested again 30 min later. PCA strongly suppressed female sexual behavior. Regardless of the presence of ARD or POA-L, no PCA injected females showed lordosis. From these results, it can be said that serotonin may not directly act on the forebrain lordosis inhibiting system.

Amphetamines↗
PubMed1988

Incidence of lordosis behavior in the female rat following removal of the vomeronasal organ.

The lordosis behavior in female rats following removal of the vomeronasal organ (VNO) was observed for a period of 14 hrs by means of a video camera monitor. Although the VNO-ablated female rats received a large number of mounts (96 to 204 times) by sexually active males, they showed only low scores (8 to 22) of lordosis quotients (number of lordosis behavior displayed/number of mounts X 100). In contrast, sham-operated females showed the highest lordosis quotients of 100 as was expected.

Animals↗
PubMed2005

Do sagittal plane anatomical variations (angulation) of the cervical facets and C2 odontoid affect the geometrical configuration of the cervical lordosis?

Anthropometric and statistical evaluation of measurements from digitization of 252 lateral cervical radiographs were used to investigate any correlation between radiographic measurements of cervical lordosis with sagittal plane facet angulation, articular pillar height, and inclination of the C2 odontoid with respect to the body of C2. Some researchers have hypothesized that facet and odontoid architecture variations can cause a reduction in cervical lordosis. To evaluate this hypothesis, the posterior aspect of the C2 dens, vertebral body corners, and superior and inferior facet surfaces of C2-C7 were digitized on 252 lateral cervical X-rays to calculate global angle, segmental angles, dens angle, facet angles, and facet height. No correlation between facet angle, articular pillar height, and cervical curve was found. Similarly, no correlation between the sagittal angle of the dens and any angle of cervical curvature was identified. There was correlation between the global ARA C2-C7 angle and the Cobb angles at C1-C7 (r = 0.71) and C2-C7 (r = 0.82). There was correlation between the global inclination of the atlas vertebral angle (APL) and the Cobb angle at C1-C7 (r = 0.66), Cobb angle at C2-C7 (r = 0.39), ARA C2-C7 (r = 0.42), and anterior translation of C2 compared to C7 (r = -0.46). Because no correlation between cervical facet and odontoid architecture and any segmental or global angle of cervical lordosis was found, conservative and surgical rehabilitative techniques aimed at the reduction of sagittal cervical deformities do not need to account for a patient's architecture of the cervical facets nor odontoid.

Adult↗
PubMed2002

Changes in lumbar lordosis in young patients with low back pain during a 10-year period.

Height and muscle strength have reportedly changed among Japanese youth during the past 10 years. Height has increased, and the back muscles have become weaker than 10 years ago. We compared the lumbar lordosis of youth today (113 men and 76 women) and of 10 years ago (85 men and 62 women). Lumbar lordosis and sacral inclination were measured on lateral standing radiographs of the lumbar spine. We also measured the same parameters among adults today (63 men and 63 women) and 10 years ago (56 men and 73 women) to study postural changes in another generation. In both men and women, the lumbar lordosis and the sacral inclination of youth today were approximately 10 degrees larger than they were 10 years ago ( P < 0.0001). However, there was no significant difference between the values among adults today and those of the same generation 10 years ago.

Adolescent↗
PubMed2000

Lordosis of lumbar vertebrae in omphalocele: an important factor in regulating abdominal cavity capacity.

PURPOSE: Although it is well known that the tiny abdominal cavity associated with larger omphalocele enlarges rapidly after surgery, the responsible mechanism remains obscure. The authors have studied the curve of lumbar vertebrae and established a hypothesis in which lordosis of lumbar vertebrae plays a major role in changing the capacity of the abdominal cavity. METHODS: Fifty-three patients with intact omphalocele and 10 normal newborns as the control were studied. The size of omphalocele was determined from the mean value of the length and breadth of the sac. The curve of lumbar vertebrae (lordotic angle) was measured using Cobb's technique on the lateral radiograph serially taken in the supine position. RESULTS: The mean lordotic angle of 53 patients was 22.2 degrees (range, 0 to 65), which was significantly greater than 11.0 degrees of the control (P <.012). The individual lordotic angle before surgery was significantly correlated with the size of omphalocele (r = 0.668, P <.0001). In serial studies carried out in 15 patients with larger omphalocele, the mean lordotic angle was decreased significantly from 30.5 degrees to 20.0 degrees (P <.009) on the first postoperative day and returned to the control level within a few weeks. CONCLUSIONS: These results suggest that severe lumbar lordosis may well become an alternative factor to produce visceroabdominal disproportion observed before surgery, and its correction after surgery may well induce the abdominal cavity to rapidly enlarge. It may be speculated that the dehiscence of abdominal rectus muscles associated with omphalocele causes the tension of ventral muscles to decline, and, then, imbalance in tension between ventral (abdominal) and dorsal (back) muscles causes the lumbar lordosis to increase. Accordingly, at the staged procedure, the prosthetic sheet should be attached under moderate tension, and its plication should be carried out at regular intervals to maintain the tension of abdominal rectus muscles.

Hernia, Umbilical↗