Flat Back Syndrome

What is Flat Back Syndrome ?

When looked at from the side, our spine has a S shaped curve with a gentle sway (Lordosis) in the low back. A condition where the spine loses its natural low back curve to become flat is known as flat back syndrome. In this condition, The patient leans forward since the spine becomes imbalanced.The Patients having flat back syndrome typically face difficulty in standing upright or complain about back and leg pain. Symptoms usually get worse as the day goes by and the patient feels they are leaning further forward if they stand upright for a longer period. The severity of the symptoms usually depends upon the amount of curvature present and difficulties with standing upright

Forward posture is usually a result of a flattened lumbar spine from degenerative changes. At times it may even be a result of spine surgery where the lordosis is not maintained. When viewed from the side, the patient’s head may be several centimeters ahead of their hips, As a result, these patients have to make compensatory efforts to maintain centre of gravity.

Surgical remedies include anterior osteotomies or Anterior lumbar fusion procedures like ALIF or OLIF, posterior fusion and instrumentation to restore normal curvature of the lower back, enabling a patient to stand upright.

What are the causes of Flat Back Syndrome ?

The flat back syndrome can occur as an outcome of any condition that shortens the front portion of the spine, causing the patient to lean forward. Flat back syndrome may develop as the result of the following causes:

  • Degenerative Disc Disease : Patients with progressive degeneration of the intervertebral discs which play a role as the shock absorbers of the spine may cause the loss of height in the front part of the spine. As discs degeneration progresses, the spine begins to lean forward and lumbar lordosis decreases. The patient may start complaining about pain as an outcome of the degenerative disc disease or as a result of the spinal imbalance.
  • Lumbar Post Laminectomy Syndrome : Patients previously treated with a laminectomy or other lumbar surgery to decompress the spinal nerves to treat stenosis may develop Lumbar flat back syndrome. These procedures can result in decrease in lumbar lordosis and in some cases spinal instability
  • Vertebral Compression Fractures : Compression fractures are often the result of weak spinal bones due to osteoporosis. A fracture can result in loss of height of the bone in the thoracic and lumbar spine. This may occur in one or multiple bones throughout the spine leading to flat back syndrome.
  • Ankylosing Spondylitis : Ankylosing spondylitis (AS) is a chronic inflammatory disease that leads to stiffness and arthritis throughout the spine. Some patients with Ankylosing spondylitis notice an increasing forward posture of the spine, along with an increase in thoracic kyphosis or decrease in lumbar lordosis. This condition may strongly lead to lumbar flat back syndrome.

How To Diagnose Flat Back Syndrome ?

The diagnosis of lumbar flat back syndrome is suggested depending upon the patient's history and x-ray and CT Scan reports of the spine . The patient usually has a difficulty in standing upright and may complain of back ache or leg pain. It is very important to study and understand the previous surgical history of the patient , which includes specific details of any past procedures. It is important to identify if the flat back syndrome is the result of a stable spinal structural abnormality or spinal instability. It is also important to identify if there is continued pressure on nerves where spinal stenosis is present.

Treatment Option:

Non-surgical treatment option : We at Pune Spine Institute have treated many patients withflat back syndrome with non surgical methods in which the Initial treatment includes an appropriate exercise routine like aerobics , weight training and weight bearing exercises and core muscle strengthening. Exercise regimes may not give radiological correction of the flat back, however, they are instrumental in decreasing patients’ pain and discomfort. Medications also play an important role in managing the symptoms of the lumbar flat back syndrome. Most of the patients with this condition have osteoporosis (Decreased bone density) so treatment is directed towards increasing the bone density. For many patients, conditioning and endurance programs can provide required strength for the symptoms to improve. Spinal Injections can serve as a relief for patients with joint arthritis or pinched nerves.

Surgical Treatment Option : Surgery may be recommended if

a) Nonsurgical treatments fail to relieve the patient from symptoms or if the deformity is worsening over time

b)Patients having curvatures leading to nerve compression causing symptoms such as numbness, weakness, or pain.

Surgical reconstruction for flat back syndrome includes some correction of the curvature.

As mentioned above, patients having structural problems or severe curvature may ultimately require surgical reconstruction may ultimately require surgical reconstruction. The aim of lumbar flat back syndrome surgery is to improve the patient's pain and spinal alignment. The team of experts at the Pune Spine Institute work to restore the normal alignment of the spine to its best in order to decrease the stress on supporting muscles of the back, hips, and legs.

Surgical remedies include anterior lumbar fusion procedures like ALIF and OLIF, Spinal osteotomies, posterior fusion and instrumentation to restore normal curvature of the lower back, enabling a patient to stand upright. These are complex surgeries, however, our team of expert doctors and support staff make your journey and recovery quite easy and comforting for your.