Curvature Pattern

[mamamax]

Is there a way to accurately asses the thoracic/lumbar curvature pattern through observation alone (in terms of left/right or right/left presentation).

If so .. how so?

[LindaRacine]

Maxene...

Thoracic curves have an apex between T2 and the T11/T12 disc.
Thoracolumbar curves have an apex between T12 to L1.
Lumbar curves have an apex between the L1/L2 disc and L4.

To get the Lenke type (1-6), one needs to know which curves are structural and which are non-structural. And, to get to the final Lenke classification (1a thru 6c), one needs to determine possible lumbar modifier and sagittal structural criteria.

--Linda

I just reread your question, and realize that I answered a question you didn't ask.

Most xrays taken in orthopaedists office have right and left sides marked. The largest percentage of curves are right thoracic and left lumbar.

Does that answer your question?

--Linda

[mamamax]

Linda ~ thank you. You did answer more than i asked and i'm glad that you did. I have a thoracolumbar/lumbar combination. I was looking for references that would provide more physical/visual definition - rather than x-rays. Like the attachment which shows a right thoracolumbar curve and right rib hump.

My question is .. if this woman in the attached picture, also had a left lumbar curve. Would this shift the rib hump to her left and also switch the hip prominence and concavity to her right? Or would visual presentation remain the same?

[LindaRacine]

Yes, the rib hump is on the same side as the curve, so someone with a left thoracic and thoracolumbar curve would have a left sided rib hump.

[mamamax]

so .. if someone has a left rib hump - they will have a left thoracic - or a left thoracolumbar curve ... regardless of whether or not there is an accompanying right lumbar curve?

And in this case then - there will be a right hip prominence and right sided concavity?

[MichelleK]

Hi maxene, what a surprise to find out you have right thorasic left lumbar eh? That would normally present with right rib hump & right hip being higher than left since the lumbar spine curves to the left. make sense? you are lucky your spinecor feels better after tightening! I feel like i'm in a straight jacket again!!! I didn't realize how it had loosened. I'm editing my post cause i think you missed it! Yes, someone will have left rib hump, lumbar curves to my knowledge won't affect rib hump, just hips etc. Yes, right hip prominence & right concavity with left thoracolumbar curve. Be careful with the terms though, thoracolumbar means c shaped curve that encompasses thorasic & lumbar spine. Double curves are called double major & can be right or left thorasic with right or left lumbar curves. Did I totally confuse you?

[LindaRacine]

so .. if someone has a left rib hump - they will have a left thoracic - or a left thoracolumbar curve ... regardless of whether or not there is an accompanying right lumbar curve?

Yes

And in this case then - there will be a right hip prominence and right sided concavity?

Not sure I follow what you're asking. If one has a left thoracolumbar curve (relatively uncommon), they may have some amount of right sided hip prominence (depending on rotation and how much of their lumbar spine is involved).

As to right-sided concavity, are you asking about the lumbar part of the curve?

[mamamax]

Yes


Not sure I follow what you're asking. If one has a left thoracolumbar curve (relatively uncommon), they may have some amount of right sided hip prominence (depending on rotation and how much of their lumbar spine is involved).

As to right-sided concavity, are you asking about the lumbar part of the curve?

ok .. let me see if i can start over and describe this better. Or ask the question better.

I one has a right thoracolumbar curve and a left lumbar curve - where would the rib hump be and where would the concavity (waist to hip) be?

[MichelleK]

what Linda has said here is true also. There may or may not be hip prominence depending on the size & rotation of lumbar curve. Same with rib hump. I've been lucky enough to avoid a rib hump although i have double major right thorasic left lumbar curves.

[MichelleK]

are you sure you have thoracolumbar curve???

[LindaRacine]

Here's a Lenke chart showing the possible configuations:

http://www.spinal-deformity-surgeon....ification.html
(click on the Lenke Classification Schematic link)

[LindaRacine]

ok .. let me see if i can start over and describe this better. Or ask the question better.

I one has a right thoracolumbar curve and a left lumbar curve - where would the rib hump be and where would the concavity (waist to hip) be?

That person would have a right rib hump and a right lumbar concavity.

[mamamax]

Hi maxene, what a surprise to find out you have right thorasic left lumbar eh? That would normally present with right rib hump & right hip being higher than left since the lumbar spine curves to the left. make sense? you are lucky your spinecor feels better after tightening! I feel like i'm in a straight jacket again!!! I didn't realize how it had loosened. I'm editing my post cause i think you missed it! Yes, someone will have left rib hump, lumbar curves to my knowledge won't affect rib hump, just hips etc. Yes, right hip prominence & right concavity with left thoracolumbar curve. Be careful with the terms though, thoracolumbar means c shaped curve that encompasses thorasic & lumbar spine. Double curves are called double major & can be right or left thorasic with right or left lumbar curves. Did I totally confuse you?

Hi Michelle! Listen, yes i'm surprised and a bit confused. I have a left rib hump - when bending forward. Major concavity on my right (unlike the lady in the picture). And yes, the right hip looks higher but if i actually place my fingers on the hip bones .. the bones appear fairly even. Torso appears shifted to my left with a left convexity.

So what would you say max is? Other than confused of course.

Hey - i'm more comfortable with the adjustment because i'm in worse shape! yes, i know - you do your exercises faithfully and i do not! Why do i not do them ... well, its important to understand what one is before one goes about trying to assist one's condition. I'm not sure i'm there yet (lol).

[MichelleK]

wouldn't the left lumbar curve cause right lumbar concavity & left lumbar would be convex? i think using the term thoracolumbar is mixing us up. If you have left thoracolumbar curve that means you have one large c shaped curve that encompasses your thorasic & lumbar spine. am i correct here linda?

[MichelleK]

Hi Michelle! Listen, yes i'm surprised and a bit confused. I have a left rib hump - when bending forward. Major concavity on my right (unlike the lady in the picture). And yes, the right hip looks higher but if i actually place my fingers on the hip bones .. the bones appear fairly even. Torso appears shifted to my left with a left convexity.

So what would you say max is? Other than confused of course.

Hey - i'm more comfortable with the adjustment because i'm in worse shape! yes, i know - you do your exercises faithfully and i do not! Why do i not do them ... well, its important to understand what one is before one goes about trying to assist one's condition. I'm not sure i'm there yet (lol).

Hmm, you have left rib hump & concavity on right in thorasic spine? It sounds to me like you are correct about the left thoracolumbar curve not left lumbar. The rib hump & concavity & left convexity would be the case with a c shaped thoracolumbar curve. do you think maybe that's the term that was used?