Key Takeaways
- Flat back syndrome is a condition in which the natural curve of the lumbar spine flattens out over time.
- Symptoms of flat back syndrome include chronic back pain, posture changes, fatigue, trouble walking, and more.
- Lumbar reconstruction surgery can help restore balance and alignment in the spine.
- NU-Spine: The Minimally Invasive Spine Surgery Institute provides spinal reconstruction for patients in New Jersey, Florida, and Pennsylvania.
What Is Flat Back Syndrome?
Patients with flat back syndrome have a lower back curve that becomes flatter over time. In people without flat back syndrome, the lower back (lumbar spine) is in a curved shape to provide flexibility and support to the spine and the rest of the body. It allows the lower body to move while maintaining balance in the upper body.
Spinal flattening can be caused by various conditions or trauma, including:
- Ankylosing spondylitis, a chronic inflammatory disease that affects the spine
- Degenerative disc disease, which affects the vertebral and intervertebral discs of the lower spine
- Compression fractures or collapsed vertebrae caused by injuries or other conditions, such as osteoporosis
- Prior fusion surgery for scoliosis, where the spine was not properly aligned
- Post-laminectomy syndrome, which occurs after complications from a laminectomy
Determining the cause of flat back syndrome is an important step in figuring out how to treat it.
What Are the Symptoms of Flat Back Syndrome, and How Do They Impact Daily Life?
Flat back syndrome can lead to several symptoms that affect patients and their ability to do daily tasks. They include:
- Persistent back, thigh, and neck pain
- Forward-leaning or stooped posture
- Fatigue
- Inability to stand upright
- Difficulty standing or walking for long periods
- Gait impairment
- Sensation of falling forward
These symptoms greatly affect patients’ mobility and, therefore, their ability to participate in everyday activities such as working, driving, caring for children, and more. Patients dealing with these effects need to turn to a medical professional to get evaluated and see if flat back syndrome is causing their symptoms.
How Is Flat Back Syndrome Evaluated?
Before treating flat back syndrome with surgery or another treatment, the patient must undergo an evaluation. This helps the physician confirm the diagnosis and develop the most effective treatment plan. It includes:
- Taking full-spine X-rays: A standing, full-length spine X-ray is used to view the entire spine and assess the degree of the curvature reduction.
- Getting advanced imaging: Other imaging, like computed tomography (CT) or magnetic resonance imaging (MRI), is often used to identify what may be causing the flat back syndrome, such as degenerated discs or prior fusion surgeries.
- Measuring sagittal balance and pelvic parameters: The sagittal balance is the natural, front-to-back alignment of the spine. It is measured using radiographic parameters to evaluate for flat back syndrome.
This evaluation helps the physician gauge how severe the flatness is and whether surgery is a treatment option.
What Are the Options for Lumbar Reconstruction?
If surgery is a suitable treatment for the patient, there are several lumbar reconstruction options that may be used. They include:
Osteotomies to Restore Alignment
For patients with severe fixed sagittal deformity, osteotomy may be used to restore normal spinal alignment. There are several posterior-based techniques for osteotomy, but they all involve removing posterior elements and/or bones to shorten the posterior column. This allows the spine to hinge open anteriorly, restoring a more natural curvature.
Extension or Revision of Prior Fusions
If flat back syndrome is caused by a prior fusion that is not aligned correctly, surgery may involve revising or extending the existing fusion. The revision procedure may involve removing old fusion hardware or extending the fusion to different levels to improve sagittal balance. This helps to restore the natural S-curve of the spine.
Use of Advanced Implants and Bone Grafts
Sometimes, flat back syndrome can be treated with advanced spinal implants, such as pedicle screws, titanium rods, and interbody cages, or bioactive bone grafts, such as bone morphogenetic proteins (BMP) and synthetic scaffolds. These tools help to correct alignment, restore a natural curve, and achieve solid, long-term spinal fusion.
Depending on the procedure used and the patient’s overall health, recovery and long-term outcomes will vary. However, NU-Spine’s board-certified spine surgeons are highly skilled in complex deformity surgery. They use minimally invasive techniques whenever possible and will give each patient an idea of what to expect before and after surgery.
Find Flat Back Syndrome Treatment Near You in New Jersey, Florida, and Pennsylvania
If you’re dealing with back pain from flat back syndrome, treatment is available. Transform your life with a touch of care at NU-Spine: The Minimally Invasive Spine Surgery Institute. Experience the cutting edge in minimally invasive spine treatments. Don’t wait for relief; schedule your appointment with our spine experts who are experienced in flat back syndrome and deformity cases. Take the first step toward a pain-free future. Contact us today to learn more or schedule an appointment at one of our New Jersey, Florida, and Pennsylvania locations.
Flat Back Syndrome and Lumbar Reconstruction FAQ
How long will I need to wear a brace or use assistive devices?
For flat back syndrome, a brace is usually worn for six weeks to six months after surgery to immobilize and protect the spine while it fuses. For non-operative cases, patients often use braces intermittently for three to four months.
How long do you stay in the hospital after lumbar reconstruction?
It depends on the type of surgery. However, most patients stay between one and four days.
Are there mobility limitations after lumbar reconstruction?
Yes, if the lumbar reconstruction includes spinal fusion, there are often permanent mobility limitations due to the stiff fused vertebrae. However, this limited mobility comes at the price of pain relief, making it worthwhile for many patients.
When should I see a spine specialist for flat back syndrome?
You should seek an evaluation if you have ongoing back pain, trouble standing upright, a forward-leaning posture, fatigue while walking, or symptoms that are limiting your daily activities.
Can flat back syndrome get worse over time?
Yes. Flat back syndrome can progress if the underlying spinal imbalance, degeneration, prior fusion issue, or deformity is not properly evaluated and treated. A spine specialist can assess your alignment and help determine the proper next step.
Is surgery always needed for flat back syndrome?
Not always. Surgery may be considered when symptoms are severe, spinal imbalance is significant, or non-surgical care is not providing enough relief. At NU-Spine, we begin with a thorough diagnosis and treatment plan.