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Flatback Syndrome & Spinal Deformities

What is Flatback Syndrome?

The human spine is naturally curved. When viewed from the front, a normal spine should seem straight and centered over the pelvis. From the side, a series of inward and outward curves should be visible throughout. In particular, these curves aid in providing balance and stability. We require both of these traits to achieve an ideal range of motion. The spine has two alternating curves: inward (lordosis) and outward (kyphosis). These two types of curves act to balance each other. In addition, they allow the head to be centered directly above the hips when standing.

When the front-to-back curvature of the back is uneven and the curves become exaggerated beyond normal ranges, this may lead to kyphosis, causing a “humpback” effect, or lordosis, causing a “swayback” effect. Conversely, when the spinal curvatures decrease beyond normal ranges, flatback syndrome may occur. Flatback syndrome is an abnormal condition where the spine loses its natural curve and begins to flatten, causing the spine to become uneven. This often results in a forward-leaning head due to the patient’s center of gravity pitching too far forward.

Common causes of flatback syndrome generally include: degenerative disc disease, lumbar post-laminectomy syndrome (flattening of the back following lumbar decompression surgery), vertebral compression fractures, osteoporosis, and ankylosing spondylitis (chronic inflammatory arthritis). Previous spine diseases and surgeries may predispose patients to flatback syndrome, particularly those who have received scoliosis treatments that use Harrington rods.

How Do I know if I Have the Symptoms of Flatback Syndrome?

Flatback syndrome can affect individuals of any age, and as with many spinal conditions, it often presents through chronic pain and difficulty standing upright. Symptoms will often worsen throughout the day. Flatback syndrome may be causing your back pain if you experience any of the following:

  • Posture Issues: Difficulty standing up
  • Chronic Pain: Recurring back, leg, hip, knee, groin, or neck pain
  • Muscular Weakness: Muscle fatigue or pain
  • Nerve (or “Radicular”) Pain: Symptoms similar to sciatica and other spinal nerve conditions
  • Forward Tilting: Leaning forward with an increasing degree the longer you stand upright
  • Pain that Interferes with Your Functioning: Inability to complete everyday tasks

Symptoms will be more severe depending on the degree of flatback syndrome present. In fact, symptoms can often become disabling and decrease day-to-day quality of life. Many patients may come to rely on medication to relieve the pain caused by flatback syndrome. This is where the Lowenstein team can help you find a treatment that works best for your particular set of symptoms.

How Dr. Lowenstein Can Help

Diagnosis of flatback syndrome usually requires an exam of the patient’s history. Your physician will determine if there has been an ongoing pattern of back pain paired with difficulty standing. Dr. Lowenstein and his team can assist you in verifying this. Whether a structural abnormality, spinal instability, or previous spinal issue caused your flatback syndrome, Dr. Lowenstein will pinpoint the cause.

In addition, remember to discuss any prior history of spinal issues or diseases requiring surgery in detail with Dr. Jason Lowenstein, orthopedic surgeon. These specifics can be vital in determining if your flatback syndrome developed as a side effect of surgery. The standard diagnostic procedure for spinal deformities includes x-rays of the spine. However, your doctor may also order MRI and CT scans to assess the health of the spine and diagnose any pinched nerves.

If flatback syndrome is causing your pain, Dr. Lowenstein and his team are here to help you choose the best treatments. Depending on the severity of flatback syndrome and its cause, there are a variety of non-surgical options for treatment, including aerobic exercise, muscle strengthening and conditioning, and physical therapy with spinal manipulation. Treatment may include pain relievers and anti-inflammatory medication. Spinal injections may also be a course of action for those with arthritis or pinched nerves.

It’s important to know that more significant structural issues may not respond to nonoperative treatment. If your condition is degenerative, spine surgery may be required in order to relieve pain and pressure on the spine and to prevent the condition from worsening. We would be happy to speak with you to discuss the best treatment options and to work with you to make your spine the healthiest it can be. Call us today to book your first appointment.