What Is Flat Back Anyway?
The lower section of your spine, called the lumbar spine, is a complex structure comprising nerves, bones, tendons, ligaments and muscles that work together. For maximum flexibility and support of this weight-bearing section of your spine, a healthy lumbar spine has a slight inward curve. This is the natural lordosis of the spine. Too much, and you’ve got swayback; too little, and you’ve got flat back.
The natural lumbar lordosis allows your lower back to move smoothly while supporting your upper body. If your lumbar spine loses its normal curvature, you’re diagnosed with flat back. This is a structural change to your spine. Flat back syndrome leads to symptoms with the potential to degrade your quality of life drastically. Some of the ways this spinal disorder affects your life include:
- Severe back pain, which inhibits your daily activities
- Difficulties working productively
- Risk of psychological disorders due to chronic pain, such as depression, mood problems and anxiety
- Risk of disability from further spinal damage and pain
- Financial strain due to costly pain management procedures
Dr. Branko Skovrlj — the leading neurosurgeon at NU-Spine, The Minimally Invasive Spine Surgery Institute, in Edison, New Jersey — treats the most complex spinal disorders, including flat back, lumbar deformity, sacroiliac joint disease, lumbar degenerative disc disease and failed back syndrome.
What Are the Signs of Flat Back Syndrome?
Flat back syndrome is a front-to-back imbalance in your spine, meaning there’s no sideways movement. The loss of your natural lumbar curvature forces the center of gravity too far forward. This results in:
- Difficulty standing upright
- Chronic pain, from the low back and down to your groin and thigh
- Difficulty completing daily tasks
- A sense of fatigue
- Weakness that gets worse with walking
- Sciatica, a pinched nerve that send pain radiating down one leg
- Spinal stenosis, with leg pain
- Stooping from fatigue at the end of the day
- A sensation of falling forward
With time, these symptoms deteriorate to a point that you may require a cane when you walk. Difficulties in walking, standing and working — regardless what your job entails — combine with chronic pain caused by a stiff spine to affect your quality of life.
What Causes Flat Back Syndrome?
Getting flat back syndrome is not fatal, and it is treatable. While it used to result from a spinal implant used to treat scoliosis, the spine condition today is normally a result of other diseases, illnesses and injuries that have gone untreated. Spinal doctors today have identified a wide range of flat back syndrome causes that include:
- Ankylosing spondylitis. A chronic arthritis-like disease that leaves your spine stiff. It also tends to straighten your spine.
- Degenerative disc disease. Degeneration of the intervertebral discs in your lumbar spine is part of the normal aging process. But it results in wear and tear that can affect your normal lordosis or curvature.
- Post-laminectomy syndrome. After a laminectomy procedure, you may notice a loss of lordosis and instability.
- Compression fractures. Any compression injury to your spine damages the entire structure.
- The collapse of a single or multiple vertebrae due osteoporosis results in a flat back.
Your spinal doctor at NU-Spine uses advanced medical procedures to diagnose the underlying cause of your flat back correctly. At the modern spinal treatment facility, doctors have access to the latest technology for diagnosis and treatment of the most complicated lower spine disorders.
Is a Flat Back Reversible?
Before commencing flat back syndrome treatment, your spine surgeon first performs a thorough evaluation of your spine. Dr. Skovrlj gives you a physical examination and reviews your medical history. If needed, you have x-rays, an MRI or a CT scan of your spine to reveal the extent its misalignment. Treatment focuses on improving your symptoms and quality of life.
The initial approach is to use conservative, non-surgical methods such as physical therapy, exercises, posture training and medications. But the most effective flat back syndrome treatment involves surgery. Your spinal surgeon is a specialist in minimally invasive spine surgery approaches. Some of the surgical procedures used at NU-Spine for flat back treatment include:
- TLIF
- XLIF/X-LIF eXtreme lateral interbody fusion
- Lumbar decompression
- Lumbar foraminotomy
- Spinal Reconstruction Surgery
- Osteotomy
