The Vault

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An overview of Fixed Sagittal Imbalance and Treatment Options

Fixed Sagittal Imbalance is a spinal condition in which there is an abnormal curve of the spine. An individual with this problem has a loss of the normal outward curve in the upper back (kyphosis) or the normal inward curve in the lower back (lordosis). The spinal curve will appear normal while the person is sitting, but upon standing the head and shoulders will be aligned in front of the hips, resulting in an excessive forward lean that prevents being able to stand up straight. Fixed Sagittal Imbalance is becoming an increasingly widespread occurrence, and is a significant cause of pain and disability.

A variety of factors causes a fixed sagittal imbalance, such as:
• Compression fractures
• Osteoporosis
• Multiple lumbar surgical fusions that cause kyphosis upon healing
• Degenerative Joint Disease
• Ankylosing spondylitis
• Spinal tumor
• Spinal infection
• Scoliosis previously treated with hardware placement
• Congenital defects
• Traumatic injury
• Spina Bifida
• Muscular Dystrophy
• Cerebral Palsy

Symptoms of a fixed sagittal imbalance include:
• Inability to stand up straight
• Difficulty walking
• Difficulty breathing in extreme cases
• Unable to look straight ahead while standing
• A significant disruption inability to perform ADL’s.
Some individuals can compensate by flexing the knees or hips to bend backward, but this places increased strain on the intervertebral discs, causing premature wear and tear.

Diagnosis of a fixed sagittal imbalance starts with a review of medical history and current symptoms. The physician will conduct a neurological exam and specific musculoskeletal assessment, with close observation of standing balance and gait. Test results from an X-ray, MRI, and CT scan will help to verify the presence of the condition.

The course of treatment for a fixed sagittal imbalance begins with pain and anti-inflammatory medications. Physical therapy and bracing can offer additional relief. If you have a spinal curvature issue and would like to find out about the treatment choices we offer, please call us at either our Seguin or New Braunfels. offices.

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