Flatback Syndrome Overview

Flatback Syndrome is a condition that occurs when there is not a normal inward curve in the low back. Typical spinal alignment consists of three curves: inner curves (lordosis) at the neck (cervical) and low back (lumbar) level, and an outer curve (kyphosis) at the trunk (thoracic) level. When these curves lose their natural balance, the low back becomes flat, causing the head to lean forward from the body and requiring and individual to correct their posture by flexing or bending at the knees. Flatback Syndrome interferes with normal daily function and is painful and disabling. The disorder is treated with conservative measures initially, and at a time requires surgery.

Causes of Flatback Syndrome include:

• A type of hardware used in the 1960’s to 1980’s to treat scoliosis
• Degenerative Joint Disease
• History of previous back surgery (Post-Laminectomy Syndrome)
• Vertebral Compression Fractures
• Ankylosing Spondylitis
• Hip flexion contractures
• Pre-existing outward curve in the trunk or low back

Some of the symptoms of Flatback Syndrome are:

• Difficulty standing straight
• Groin and thigh pain
• Increased fatigue during the day
• Sciatica
• Upper back and neck pain
• Spinal Stenosis

Flatback is diagnosed initially with a physician’s careful review of medical history and physical exam, accompanied by a standing x-ray. An MRI, CT scan, and myelogram are also useful in verifying the disorder, and along with the x-ray will aid in determining whether the spinal alignment is the result of a stable structural abnormality or actual spinal instability.

Treatment for Flatback Syndrome starts with non-steroidal anti-inflammatory medication for pain relief and spinal injections when necessary. Physical Therapy consisting of core strengthening, aerobic exercise, and manual manipulation is also beneficial. If these conservative measures are inadequate, surgical intervention is the next step. The surgical procedure used most often for Flatback Syndrome is an Osteotomy (removal of part of a vertebral bone). Early evaluation by a spine specialist is essential so that treatment can begin promptly, which can lessen the extent of possible surgery.

If you have Flatback Syndrome and would like to learn about out treatment options, please contact our Seguin or New Braunfels office.