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PubMed2004

Medial preoptic area delta-opioid receptors inhibit lordosis.

Endogenous opioid peptides that activate the delta-opioid receptor (DOR) are thought to facilitate female receptive behavior. This facilitation of lordosis has been demonstrated by intracerebroventricular infusions and injection of DOR-active ligands into the ventromedial hypothalamic nucleus, an area with robust DOR binding. However, DOR binding is distributed throughout the hypothalamus, and the role of DOR in other areas of the hypothalamus has not been examined. In the current study, we demonstrated DOR immunoreactivity in the medial preoptic area (MPO), in particular medial preoptic nucleus (MPN) of the preoptic area. DOR immunoreactive processes were sparsely distributed in the medial and lateral parts of the MPN. Larger DOR immunoreactive fibers were localized in the ventrolateral aspect of the lateral MPN. The MPN is involved in the modulation of female sexual receptivity and the distribution of DOR in this area suggested to us that DOR may regulate lordosis. Ovariectomized rats with unilateral cannulae aimed at the MPN were given 5microg 17beta-estradiol benzoate (EB), once every 4 days and tested for lordosis. [D-Pen(2), D-Pen(5)]-enkephalin (DPDPE), a DOR agonist, microinfused into the MPO, 52-54h after EB-priming, inhibited lordosis when compared with the aCSF (vehicle) control (P <== 0.05). The inhibitory effects of DPDPE were reversed by microinjection of naltrindole, a DOR antagonist (P <== 0.05). Interestingly, the DOR inhibition of lordosis is similar to the micro-opioid receptor inhibition of lordosis in the MPN. These results indicate that DOR in the MPO, particularly in the MPNm, plays an important role in the regulation of lordosis.

Animals↗
PubMed2003

Restraint accentuates the effects of 5-HT2 receptor antagonists and a 5-HT1A receptor agonist on lordosis behavior.

The effect of restraint on lordosis behavior was examined in proestrous and ovariectomized, hormone-primed rats. Restraint durations from 5 to 60 min had no effect on lordosis behavior of proestrous rats. There was also no effect of 5 min restraint on lordosis behavior of ovariectomized rats hormonally primed with 10 microg estradiol benzoate and 500 microg progesterone. However, after intraperitoneal treatment with 1.0 mg/kg ketanserin tartrate (ketanserin), 5 min of restraint significantly reduced lordosis behavior of both groups of rats. The 5-min restraint combined with 0.50 or 0.75 mg/kg ketanserin reduced lordosis to mount (L/M) ratios of ovariectomized rats, while L/M ratios of proestrous rats were inhibited only by the 1.0 mg/kg dose. Increasing the restraint duration (10 or 15 min) reduced the dose of ketanserin necessary to reduce the L/M ratios of proestrous rats. Treatment with the selective serotonin (5-HT)(2C) receptor antagonist, SB206553 (2.5 or 5.0 mg/kg), in combination with 5 min of restraint, also reduced L/M ratios of hormonally primed, ovariectomized rats. The neural sites responsible for ketanserin's additivity with restraint are unknown, but infusion of the drug into the ventromedial nucleus of the hypothalamus (VMN) did not mimic the systemic treatment. However, 5 min of restraint did enhance the effects of VMN infusion with the 5-HT(1A) receptor agonist, 8-OH-DPAT. In contrast, 8-OH-DPAT's systemic potency was not enhanced by restraint. These findings support the hypothesis that a mild stressor increases the lordosis-inhibiting effects of 5-HT(1A) receptor agonists and that 5-HT(2) receptors may protect against such disruption of lordosis behavior.

Animals↗
PubMed1992

A review and reevaluation of the role of serotonin in the modulation of lordosis behavior in the female rat.

The role of serotonin (5-HT) in the modulation of sexual receptivity (lordosis) in the female rat is reviewed and reevaluated. The effects on lordosis of drug treatments that decrease or increase the activity and availability of central 5-HT are first discussed, and this is followed by an evaluation of the effects of drugs that act directly at 5-HT receptors. In order to shed light on the physiological significance of effects of serotonergic drugs on lordosis, there is also a review of what is known of changes in levels of serotonergic activity and densities of 5-HT receptors in the female rat brain that take place through the estrous cycle and in response to administration of behaviorally effective doses of gonadal steroids. Serotonin has generally been thought to have a tonic, inhibitory effect on lordosis. However, it is concluded that 5-HT can either inhibit or facilitate lordosis depending on which subtypes of central 5-HT receptors become activated. Because of a lack of consistent or compelling evidence of effects of ovarian hormones on serotonergic activity or 5-HT receptors in critical areas of the brain, it is stated that there is at present no basis to conclude that the effects of pharmacological manipulations of serotonergic activity on lordosis reflect an important, physiological role of 5-HT in the modulation of lordosis behavior in the female rat.

Animals↗
PubMed1987

The effect of Harrington rod contouring on lumbar lordosis.

The effect of Harrington rod sagittal plane contouring, or lack of it, on total lumbar, segmental lumbar, and lumbosacral lordosis was studied retrospectively in a series of 36 patients operated on for idiopathic scoliosis. Regardless of contouring, there was a decrease in total lumbar lordosis and lordosis above L4, with an increase in lordosis below L5. Although not statistically significant, patients with contoured rods had less loss of segmental (L1-4) lordosis and less increase in segmental lumbosacral lordosis (L4-S1) than the noncontoured group. Although helpful, additional steps beyond concave rod contouring appear to be necessary to consistently preserve lumbar lordosis.

Adolescent↗
PubMed2001

Range of motion and lordosis of the lumbar spine: reliability of measurement and normative values.

STUDY DESIGN: Repeated measures for intratester reliability were performed. OBJECTIVES: To investigate the intratester reliability of a new measurement technique that evaluates lumbar range of motion in three planes using a pelvic restraint device, and to examine the reliability of lumbar lordosis measurement by inclinometer technique. Preliminary normative data on lumbar range of motion and lumbar lordosis were collected for comparison with the findings of previous studies. SUMMARY OF BACKGROUND DATA: Various noninvasive measurement methods have been developed for recording lumbar range of motion. However, pelvic movement was not effectively restricted during the use of these measurement techniques. The use of the pelvic restraint device to measure lumbar range of motion has not been investigated previously. Very few studies have investigated the reliability of quantifying lumbar lordosis by the inclinometer technique. METHODS: Normative values were measured in 35 healthy men, and 12 of these subjects were included for the reliability study. Pelvic motion was limited by the pelvic restraint device during lumbar range of motion measurement in standing. An inclinometer was used for evaluation of lumbar flexion, extension, lateral flexion, and lumbar lordosis, whereas a lumbar rotameter was used to measure axial rotation. RESULTS: Good intratester reliability was shown in the lumbar range of motion and lordosis measurement. Most of the intraclass correlation coefficient and Pearson's r values (accompanied with nonsignificant paired t tests) were greater than 0.9, and most of the intrasubject coefficients of variation were less than 10%. The values of lumbar range of motion in three planes and lumbar lordosis found in the current study were comparable with those from most of the previous studies on these measurements in the normal population. CONCLUSIONS: Inclinometer and lumbar rotameter measurements with the use of a pelvic restraint device are reliable for measuring lumbar spine range of motion. Use of the inclinometer technique to record lumbar lordosis also is a reliable measure.

Adult↗
PubMed1980

Ablations of lumbar epaxial musculature: effects on lordosis behavior of female rats.

Ablations of lateral longissimus, medial longissimus, and the lumbar transversospinalis system were performed singly and sequentially on female albino rats. Animals were tested postoperatively with males and by manual stimulation for lordosis. In tests with males, the strength of lordosis was rated specifically with respect to the extent of rump elevation; in manual stimulation tests, rating was based on the full lordotic response. Animals were also tested for the ability to cross a balance beam as an indication of the general status of the animals' posture and locomotion. The data from tests with males proved more sensitive in showing up effects of the ablations on lordosis. Lateral longissimus ablations and transversospinalis ablations led predictably to worsened lordosis. Medial longissimus ablations did not significantly affect lordosis. The manual stimulation data were consistent with the data obtained in tests with males. Ablated animals were not impaired on the balance beam test. The results indicate that lateral longissimus and the lumbar transversospinalis system are major participants in the rump elevation of lordosis, an early and biologically important component of the lordotic response. This information permits focus on lateral longissimus and the lumbar transversospinalis system in the investigation of the neural control of lordosis.

Animals↗
PubMed1984

Modulation of lordosis behavior of female rats by naloxone, beta-endorphin and its antiserum in the mesencephalic central gray: possible mediation via GnRH.

The role of endogenous opiate peptides in the mesencephalic central gray (MCG) and their possible interactions with gonadotropin-releasing hormone (GnRH) in the regulation of lordosis behavior was assessed in ovariectomized, estrogen-treated and estrogen-progesterone-treated female rats. Lordosis behavior triggered by male mounting was enhanced by microinfusion of naloxone and anti-beta-endorphin-globulin (anti-beta-end-G) but not by anti-met-enkephalin-globulin or anti-dynorphin-globulin into the MCG in both estrogen-treated and estrogen- (low dose) progesterone-treated females. The potentiating effects of naloxone and anti-beta-end-G could be blocked by a preinfusion of either anti-GnRH-globulin or an antagonist analog of GnRH directly into the MCG. However, two potent antagonist analogs of GnRH were not effective in blocking lordosis indicating a dissociation between their neural actions and their known inhibitory effects on luteinizing hormone release. Conversely, beta-endorphin but not met-enkephalin or dynorphin infused into the MCG inhibited lordosis behavior in both estrogen-treated and estrogen-progesterone-treated rats. This beta-endorphin-induced inhibition of lordosis in the estrogen-treated rats could be overcome by GnRH microinfused directly into the MCG which potentiated lordosis to high levels. These observations provide evidence that beta-endorphin may be the sole opiate peptide in the MCG involved in the control of lordosis behavior and also suggests a functional relationship with GnRH systems in the MCG in such a regulatory mechanism.

Animals↗
PubMed2003

Fluoxetine may influence lordosis of rats through effects on midbrain 3 alpha,5 alpha-THP concentrations.

5alpha-pregnan-3alpha-ol-20-one (3alpha,5alpha-THP) in the ventral tegmental area (VTA) mediates lordosis of rodents. If fluoxetine's effects on lordosis are mediated in part by midbrain 3alpha,5alpha-THP, then fluoxetine regimens that decrease and increase lordosis would be expected to respectively lower and elevate midbrain 3alpha,5-THP levels. Experiment 1: Ovariectomized (ovx) rats received estradiol benzoate (EB; 5 micro g, SC) at 0 and 24 h and fluoxetine (20 mg/kg, IP) or vehicle 30 min before sex testing and tissue collection. Other rats received fluoxetine (10 mg/kg, IP) or vehicle for 15 days followed by EB-priming and testing. Systemic acute or chronic fluoxetine significantly decreased lordosis and midbrain 3alpha,5alpha-THP levels compared to vehicle. Experiment 2: Ovx rats with unilateral cannula to the VTA were primed with EB (5 micro g; 0, 24 h) and/or progesterone (0 or 100 micro g; 44 h, SC). At 47.5 h, fluoxetine (3.6 mM) or vehicle was infused to the VTA. At 48 h, rats were tested. Administering fluoxetine to the VTA significantly increased lordosis and midbrain 3alpha,5alpha-THP levels compared to vehicle infusions. Experiment 3: Ovx EB-primed rats were tested prior to, and 30 min after, treatmemt with acute fluoxetine (20 mg/kg, IP). Rats were then infused with 3alpha,5alpha-THP (100 ng) or vehicle to the VTA and were retested. 3alpha,5alpha-THP, but not vehicle, to the VTA reversed acute fluoxetine's inhibitory effects on lordosis. Together, these data suggest fluoxetine may alter lordosis in part through actions of 3alpha-THP in the midbrain.

Animals↗
PubMed1979

Effects of hypothalamic deafferentation on hormonal facilitation of lordosis in ovariectomized rats.

Lordosis response in estradiol benzoate (EB)-progesterone (P) primed castrated female rats was studied after 4 types of deafferentation of the medial hypothalamus. Tests were started 4-5 weeks after the brain surgery and ovariectomy. Anterior deafferentation (half-dome cut) at the level behind the suprachiasmatic nucleus (AD-I) and island isolation of the medial basal hypothalamus (MBH island) were highly effective to suppress lordosis response in EB-P primed females. However, the cuts placed dorsal (AD-II) or posterior (AD-III) to the AD-I were without apparent suppressive effect on the EB-P induced display of lordosis. These results suggest that the anterolateral fiber connection with the MBH may participate in lordosis facilitatory mechanisms in EB-P primed females. When reserpine (R) was injected instead of P to EB-primed rats, R effectively facilitated lordosis response in rats with or without the deafferentation (AD-I or MBH island). This suggests that the MBH is not necessary to facilitate lordosis in EB-R primed rats. The site of action of R in the central nervous system for facilitating lordosis may not be the same as that of P.

Afferent Pathways↗
PubMed1981

Evidence that a placental factor other than androsterone or dihydrotestosterone inhibits oestrogen-induced lordosis behaviour in pregnant rats.

Daily administration of oestradiol benzoate, beginning 10 days after mating, stimulates lordosis behaviour in deciduomata-bearing pseudopregnant rats, but not in pregnant rats. The inhibition of this behaviour during pregnancy was not prevented by reducing the number of conceptuses to two, by removing the fetuses while leaving the placentas in utero, or by removing the ovaries and administering progesterone to prevent abortion. Removal of the uterus or fetuses and placentas on day 12, however, led to high levels of lordosis behaviour. Thus, it is likely that the placenta produces a factor which inhibits the behavioural responsiveness to oestrogen. Plasma levels of progesterone, androsterone and dihydrotestosterone were higher during the second half of pregnancy than in the second half of pseudopregnancy prolonged by uterine decidualization. The possible involvement of these steroids in the inhibition of lordosis behaviour was investigated by increasing their levels in deciduomata-bearing pseudopregnant rats and determining the effect on oestrogen-induced lordosis behavior. Little suppression of this behaviour was seen when the pseudopregnant rats were treated with progesterone or androsterone whereas treatment with dihydrotestosterone resulted in a significant inhibition of lordosis behavior. However, the dose of dihydrotestosterone required to do so resulted in high, non-physiological plasma levels of this steroid. No inhibition of lordosis behaviour was observed when dihydrotestosterone levels were approximately threefold those normally present in pregnant rats. It is concluded that none of these three steroids is primarily responsible for the suppression of lordosis behaviour during pregnancy.

Androsterone↗
PubMed1996

The effects of pelvic movement on lumbar lordosis in the standing position.

The purpose of this study was to investigate whether the maneuver of altering the angle of pelvic tilt when standing is effective in changing the angle of lumbar lordosis. The importance of the study was to establish a scientific basis for a common clinical assumption. Pelvic tilt and lumbar lordosis were measured during three conditions: with subjects in a normal standing posture, with subjects assuming a maximal anterior pelvic tilt posture, and with subject assuming a maximal posterior pelvic tilt posture. Measurements of pelvic tilt and lumbar lordosis were obtained using a television/computer system that obtained the three-dimensional coordinates of markers on the pelvis and spine at 20-msec intervals. Each measurement was made three times, and all were found to be reliable, with intraclass correlation coefficients (3,1) ranging from 0.78 to 0.95 (p < 0.001). Adopting a maximal anterior pelvic tilt changed the pelvic attitude relative to the horizontal by an average fo 11.4 degrees (p < 0.001) and increased the lumbar lordosis by an average of 10.8 degrees (p < 0.001). Adopting a maximal posterior pelvic tilt changed the pelvic attitude by an average of 8.7 degrees (p < 0.001) and decreased the lumbar lordosis by an average of 9.0 degrees (p < 0.001). The results of this study demonstrate that altering the pelvic tilt significantly changes the angle of lumbar lordosis. This lends support to the use of pelvic tilting exercises to increase or decrease the degree of lumbar lordosis, at least for the duration of the exercise.

Adult↗
PubMed1988

Loss of lumbar lordosis. A complication of spinal fusion for scoliosis.

Symptomatic loss of lumbar lordosis is a disabling complication of scoliosis surgery. This so-called "flat-back syndrome" is characterized by an inability to stand erect and by upper back pain. Distraction instrumentation extending into the lower lumbar spine or sacrum is the most frequently identified etiologic factor responsible for loss of lordosis. The more distal the level of instrumentation, the severer the loss of lumbar lordosis. Other factors that may aggravate the loss of lordosis include thoracolumbar kyphosis, fixed thoracic kyphosis, hip flexion contractures, and pseudoarthrosis. Because of the wide range of values for kyphosis and lordosis in normal individuals, there is no absolute value that can be considered "normal." It is the overall sagittal plane balance that is most important. The most useful radiographic measurement to evaluate this sagittal plane balance is the full-length standing lateral radiograph with the knees extended. On this view, the C7-S1 measurement should fall within 2 cm of the anterior aspect of the sacrum. Surgical treatment for symptomatic loss of lumbar lordosis consists of closing wedge osteotomies through the fusion mass. This should generally be preceded by an anterior release and interbody fusion. Correction should be obtained at the site of the deformity with particular attention paid to the thoracolumbar junction. The surgery is difficult and the risk of complication is high. The most important aspect of this postural disorder is prevention. Avoid distraction instrumentation that extends into the lumbar spine if possible. When distraction instrumentation is used, the techniques described will help preserve lumbar lordosis. When performing a fusion to the sacrum, distraction instrumentation should not be used.

Humans↗
PubMed1979

Facilitation of the lordosis reflex of female rats from the ventromedial nucleus of the hypothalamus.

1. Effects of electrical stimulation of hypothalamic ventromedial nucleus (v.m.n.) on the lordosis reflex of female rats were examined in ovariectomized and oestrogen-primed animals with chronically implanted electrodes. 2. Lordosis triggered either by manual cutaneous stimulation or by male mounting, was facilitated by electrical stimulation of the v.m.n. 3 A gradual increase in lordosis performance followed a relatively long period of stimulation; never less than 15 min and usually about 1 hr of stimulation was necessary for maximum facilitation. Following the termination of stimulation, the performance returned gradually to the control level during a 5--8 hr period. 4. The optimal frequency of stimulation was between 10 and 30 Hz. Threshold for effective facilitation was, on the average, 12.5 microA. 5. Stimulation tended to induce larger facilitation when applied to the lateral side of v.m.n. 6. Pre-treatment with oestrogen was necessary to obtain facilitation by v.m.n. stimulation. The threshold dosage of oestrogen was 2.5 microgram per animal. 7. Stimulation was effective in adrenalectomized rats, in dexamethasone-primed animals, and in rats pre-treated with exogenous progesterone. Thus, adrenal prodesterone release is not required for the v.m.n. facilitation of lordosis. 8. Medial preoptic stimulation with the same parameters suppressed the lordosis reflex. 9. The v.m.n. participates in the control of lordosis by a facilitatory output. The delay before facilitation implies that the v.m.n. is not in the direct reflex-arc for the execution of lordosis. Rather, a summation or interaction process with an unusually long time course is involved.

Animals↗
PubMed1993

Mechanics of anatomic reduction of thoracolumbar burst fractures. Comparison of distraction versus distraction plus lordosis, in the anatomic reduction of the thoracolumbar burst fracture.

The adequate reduction of vertebral burst fractures is dependent on successful application of distractive forces in combination with the restoration of normal spinal lordosis. However, the optimal sequence of distraction in comparison to distraction plus lordosis in the anatomic restoration of the fractured thoracolumbar spine has not been described. Burst fractures of the L1 vertebra were first created and the reduced in vitro using three differing reduction techniques. In six fresh human cadaver spine specimens, the mean fracture severity based on the degree of canal compromise was 31% (SD +/- 20%) after fracture. Reductions were performed using the AO Fixator Intern, the Reduction Fixation (RF) Device, and the Steffee plate systems following standard clinical techniques. The AO Fixator Intern provided independent but variable control of distraction and lordosis, the RF device provided variable distraction with independent, but preset, correction of lordosis and the Steffee system provided set distraction and stabilization. Both the AO and RF devices restored the lordosis (7.6 degrees +/- 5.2 degrees and 9.7 degrees +/- 4.5 degrees, respectively) better than the Steffee plate system (0 degrees +/- 1.6 degrees). However, the AO device provided poorest restoration of the posterior vertebral body height (92% vs 96% for the RF device and 99% for the Steffee plate). The RF device, which restored both lordosis and posterior vertebral body height to the near anatomic prefracture level, provided significantly better canal clearance (9% +/- 8%) than the other techniques, P < 0.05. The study demonstrates that instrumentation systems that provide independent correction of distraction and lordosis can best restore anatomic alignment, with indirect neurodecompression of the compromised spinal canal.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2001

Comparison of axial and flexural stresses in lordosis and three buckled configurations of the cervical spine.

OBJECTIVE: To calculate and compare combined axial and flexural stresses in lordosis versus buckled configurations of the sagittal cervical curve. DESIGN: Digitized measurements from lateral cervical radiographs of four different shapes were used to calculate axial loads and bending moments on the vertebral bodies of C2-C7.Background. Osteoarthritis and spinal degeneration are factors in neck and back pain. Calculations of stress in clinically occurring configurations of the sagittal cervical spine are rare. METHODS: Center of gravity of the head (inferior-posterior sella turcica) and vertebral body margins were digitized on four different lateral cervical radiographs: lordosis, kyphosis, and two "S"-shapes. Polynomials (seventh degree) and stress concentrations on the concave and convex margins were derived for the shape of the sagittal cervical curvatures from C1 to T1. Moments of inertia were determined from digitizing and the use of an elliptical shell model of cross-section. Moment arms from a vertical line through the center of gravity of the head to the atlas and scaled neck extensor moment arms from the literature were used to compute the vertical component of extensor muscle effort. Segmental lever arms were calculated from a vertical line through C1 to each vertebra. RESULTS: In lordosis, anterior and posterior stresses in the vertebral body are nearly uniform and minimal. In kyphotic areas, combined stresses changed from tension to compression at the anterior vertebral margins and were very large (6-10 times as large in magnitude) compared to lordosis. In kyphotic areas at the posterior vertebral body, the combined stresses changed from compression (in lordosis) to tension. CONCLUSIONS: The stresses in kyphotic areas are very large and opposite in direction compared to a normal lordosis. This analysis provides the basis for the formation of osteophytes (Wolff's Law) on the anterior margins of vertebrae in kyphotic regions of the sagittal cervical curve. This indicates that any kyphosis is an undesirable configuration in the cervical spine. Relevance. Osteophytes and osteoarthritis are found at areas of altered stress and strain. Axial and flexural stresses at kyphotic areas in the sagittal cervical spine are abnormally high.

Adult↗
PubMed1987

Relationships between lumbar lordosis, pelvic tilt, and abdominal muscle performance.

The purpose of this study was to examine the relationships between measurements of lumbar lordosis, pelvic tilt, and abdominal muscle performance during normal standing. In addition, the reliability of the measurements used in this study was examined. Measurements of lumbar lordosis, pelvic tilt, and abdominal muscle performance were taken of 31 healthy adults aged 20 to 33 years. Each measurement was taken twice, and the measurements were shown to be reliable. The Spearman's rho correlation of the abdominal muscle performance measurements with pelvic tilt was .18 and with lordosis was .06. The Pearson product-moment correlation of lordosis with pelvic tilt was .32. The results indicate that lumbar lordosis, pelvic tilt, and abdominal muscle function during normal standing are not related. This study demonstrates the need for a reexamination of clinical practices based on assumed relationships of abdominal muscle performance, pelvic tilt, and lordosis.

Abdominal Muscles↗
PubMed1996

Lumbar lordosis and pelvic inclination of asymptomatic adults.

BACKGROUND AND PURPOSE: We examined the association between pelvic inclination and lumbar lordosis during relaxed standing and eight variables thought to contribute to lordosis. SUBJECTS: Ninety subjects (45 men, 45 women) without back pain or a history of surgery were examined. The mean age was 54.8 years (SD = 8.5) for male subjects and 58.9 years (SD = 8.8) for female subjects. METHODS: Multiple linear regression modeling was used to assess the association of pelvic inclination and size of lumbar lordosis in a standing position with age, gender, body mass index, physical activity level, back and one-joint hip flexor muscle length, and performance and length of abdominal muscles. RESULTS: Abdominal muscle performance was associated with angle of pelvic inclination for women (R2 = .23), but not for men. Standing lumbar lordosis was associated with abdominal muscle length in women (R2 = .40), but it was multivariately associated with length of abdominal and one-joint hip flexor muscles and physical activity level in men (R2 = .38). No correlation was found between angle of pelvic inclination and depth of lumbar lordosis in a standing position. CONCLUSION AND DISCUSSION: Neither univariate nor multivariate regression models account for variability in the angle of pelvic inclination or size of lumbar lordosis in adults during upright stance; no correlation was found in standing between these two variables. The use of abdominal muscle strengthening exercises or stretching exercises of the back and one-joint hip flexor muscles to correct faulty standing posture should be questioned.

Abdominal Muscles↗
PubMed1990

The lumbar lordosis below Harrington instrumentation for scoliosis.

This retrospective study evaluates lumbar lordosis in 43 patients before and after Harrington instrumentation into the lumbar spine. The authors measured overall lumbar lordosis, lordosis of unfused lumbar levels, and sagittal vertical axis. Lordosis decreased progressively in lower levels of fusion. The increase in lordosis below the fusion did not compensate for the overall loss of lordosis. The sagittal vertical axis moved forward, producing a subtle, asymptomatic form of flat back syndrome.

Humans↗