The human spine has two curves that help to carry the weight of the arms, trunk, and neck in a properly balanced way. The pelvis is joined to the spine curves as they are slightly backward. This spine curve is called lordosis. The curves slightly forward at the chest level where ribs join the spine, this curve is known as kyphosis.
There is a loss of lordosis or kyphosis, or both make the flatback syndrome happen. The loss will make your spine straight. It is an abnormal condition where the spine become flat because it loses the lumbar lordosis. The person with flatback syndrome finds it difficult to stand upright or straight.
Symptoms
Flatback syndrome patient may feel the following symptoms:
- A person may find difficulty in maintaining proper posture.
- A person with flatback syndrome feels low back pain and thigh pain.
- Find troubling with a daily task such as stand upright or walk.
- Daily fatigue might increase the symptoms such as contract the back muscles and possibly flex at the knees and hips.
- The patient might also have neck pain and upper back pain due to always trying to realign.
- The patient might feel difficulty in bending.
- Numbness or sensation in the legs.
What are the causes of flatback syndrome?
This syndrome can occur after scoliosis has corrected. In scoliosis correction procedure, the rods are used to straighten the abnormal curve, but sometimes it also straightens the normal curves of the back. Another cause may be the surgical procedure such as a lumbar spinal fusion or a laminectomy that disturb the normal curve and make it straight.
The flat back syndrome may occur as the result of the following: Lumbar Post Laminectomy Syndrome, Degenerative Disc Disease, Ankylosing Spondylitis, Compression Fractures.
Lumbar Post Laminectomy Syndrome: As we mentioned before that, this syndrome may develop in a person that previously treated with lumbar surgery to decompress the spinal nerves to treat stenosis or a laminectomy. So, after this procedure, a person may lose the lumbar lordosis, or sometimes it causes spinal instability.
Degenerative Disc Disease: In some cases, the shock absorbers of the spine or the progressive degeneration of the intervertebral discs may become the reason for height loss in the front part of the spine. The spine begins to move forward when the discs degenerate, and lumbar lordosis decreases when it happens. The pain will start because of spinal imbalance or the degenerative disc disease.
Ankylosing Spondylitis: A chronic inflammatory disease that causes arthritis and stiffness throughout the spine called Ankylosing Spondylitis. A patient suffering from ankylosing spondylitis may notice an increasing forward posture of the spine, including a decrease in lumbar lordosis or an increase in thoracic kyphosis. It may result in lumbar spine straightening.
Vertebral Compression Fractures: Osteoporosis makes the bones weak, including the spinal bones, compression fractures are often caused as a result of weak spinal bones. When a fracture occurs, it can lead to the loss of height of bone in the lumbar spine. It could be in one bone or multiple or even throughout the spine, which results in the flatback syndrome.
How to Diagnose Flatback Syndrome?
The physician will examine the patient first and see the symptoms that the patient feels any difficulty standing upright and may having back or leg pain. It will also be based on the patient’s medical history, such as including the details of any past injury, bones issue, or surgery. To determine that the patient have a flatback syndrome or not, the doctor will require a full-length X-ray of the spine that includes images of the spine, bones, and tissues.
The doctor can also ask for the other diagnostic procedures to have a look at the detailed image of the spine:
MRI: Magnetic resonance (MR) imaging scan is used to identify that the spinal cord (A fragile tube-like structure that includes the bundle of nerves connecting body and brain) is affected by the spinal curvature or not. Radio and magnet waves are used to give detail images of the spinal cord.
CT Scan: A CT scan is also called a computed tomography scan. It produced more informative, focused, and clear images than a general X-rays. It shows the images of bones, soft tissue, intervertebral discs, organs, and the spinal cord clearly in white, grey, color, or black tones.
Remember, it is essential to find out that the flatback syndrome is the result of spinal instability or the stable spinal structural abnormality — one more thing to determine if there is any continued pressure on nerves where spinal stenosis is present.
What are the Treatments for Flatback Syndrome?
For flatback syndrome, there are surgical and non-surgical both treatments available, but it depends on the patient’s condition.
At the initial stage, non-surgical treatments will be recommended, and these include physical therapy, appropriate exercise routine (aerobic fitness, core muscle strengthening exercise, and weight-bearing exercise) and pain killers. There are some medicines used to treat the symptoms of lumbar spine straightening. Spinal injections also provide relief.
If there is no relief or recovery even after trying the non-surgical methods, then you might require surgery. The operation aims to correct the spine by preventing any misalignment and also provide relief from pain. There are multiple methods of surgery that correct flatback deformity. The pedicle subtraction osteotomy is a procedure in which a bone from the back of the lumbar spinal column is removed by the surgeon. It can be realigned by the surgeon to the bones of the spinal column, introducing the necessary lordosis.
Another procedure is used to re-establish the stability and strength of the spine through a spinal fixation and fusion. The surgeon inserts hardware like rods and screws that hold the spine in place while the bones fuse is known as fixation procedure. When the surgeon place grafting material between bones of the spine to grow them together into one solid bone is called fusion procedure.
So, in case if you notice any symptoms or feel pain in the back then book your appointment and visit your physician. Don’t take your back lightly.