Question
My son is 11 yr old. He use to complaint back pain. I got his x-ray done. The report shows that the normal lumbar lordosis is lost and s1 spina bifida occult is present. I want to know what problems he may face in future and what kind of treatment is required. Tell me some physical exercises which can help him.

Answer
Dear Hema,

This is not as bad as you think.  Spina Bifida occulta is a self limiting condition of the spine in which the posterior portion of the vertebral canal/arch did not form completely.  This happens in utero development.  It is mostly an incidental finding which requires no treatment.  In rare cases surgical fusion may be needed if the area is unstable, but again this is very rare.  I see spina bifida occulta in my patients frequently.

Now loss of the lumbar lordosis has future consequences such as accelerated degeneration of the spine over time, but your son is still young and his lumbar lordosis can easily be improved with mild traction techniques.  I have had success with this type of treatment in adults, and children are even easier to treat.  The basic idea is to use a fulcrum (rounded wedge) which creates pressure into the spine while initiating a bending moment in the spine while he lays flat on his back thereby utilizing the effect of gravity to stretch the ligaments of the spine and allow a more proper configuration...sound complicated, but it is relatively simple.  It utilzes a principle of tissue called viscoelasticity in which tissue will change in response to stress, and this is called creep, hysteresis, and set.  After an initial examination and education of proper technique this can often be addressed at home with children.

I would recommend that you check out this website:  www.idealspine.com.  
Read the information so that you have abetter understanding of how this works, and find a doctor near your locale in which you can initiate proper instruction and care.  A devise you should also check out is the posture pump...again this can be used at home.  I have recommended it to my patients with similar problems and it really help alleviate spinal tension and promote proper weight distribution while standing and sitting.

Concerning exercises there is a specific exercise I would recommend called a birdog exercise.  It promotes core stabilization of the multifidus muscle which is the main postural muscle of the spine.  It attaches to the disk and the facet joint of the spine thereby giving great support.  There is a picture of this exercise included in an article at:  

http://www.acefitness.org/getfit/exercise_display.aspx?pageID=687

If you have any further comments or questions Hema, feel free to write back.

Respectfully,
Dr. J. Shawn Leatherman