Chronic compensation from PIEX is most likely to produce which spinal change?

• A. Hypolordosis
• B. Hyperlordosis
• C. Kyphosis
• D. Neutral

Answer: (B)

Chronic pelvic imbalance tends to push the pelvis into forward tilt, and the spine adapts to keep the head over the pelvis and maintain balance in the sagittal plane. The most efficient way to do that is by increasing the inward curve of the lumbar spine, producing hyperlordosis. This hyperlordotic pattern allows the upper body to stay aligned over the hips despite the pelvic tilt, minimizing compensatory stress elsewhere.

If the pelvis tilts forward chronically, a flattening of the lumbar curve (hypolordosis) would worsen the balance, not improve it. Thoracic rounding (kyphosis) is a different regional adaptation and isn’t the typical lumbar compensation for forward pelvic displacement. Neutral would imply no compensatory change, which isn’t consistent with a persistent pelvic imbalance.