Flat Back Syndrome
 

I am convinced that i have flat back syndrome. I am now after many spinal surgeries fused from C4 thru L4. Well some areas have not fused and i am recovering from my last surgery .
My symptoms are a straight looking lower back with loss of the lumbar lordosis. I am unable to stand up straight and when i do try i always have my knees bent to try to compensate. My upper back gets very fatigued when walking or standing for any period of time. It is also not possible to stand up without holding on to something for more than a few minutes. Of course along with this is pain in my lumbar area , pain in my hips at times and the knees.

Anyone with any experience ? I would appreciate any info.
thanks
judy

Judy, I've had quite a few clients with flat back. In all the cases I'm familiar with, it has been somewhat irrelevant. It may be used to explain more rapid degeneration of portions of the spine, but I think it's kind of a "which came first, the chicken or the egg" discussion.

Do you have some lateral views you can post?

Mark

I don't have any lateral views yet. I am seeing my spine doc on Tuesday. I will bring it up then.
Is surgery the only thing that really works to fix this situation? :confused: I've read that physical therapy should be tried first , but to me it seems like a waste of time.

judy

did you see
 

Judy,
Did you see Dr.Pashman's (in LA) website? I had googled Flat Back Syndrome and checked that and some other sites out and his had a pretty good explanation of the syndrome and surgery. Will be interested to hear what your doctor says.

It would seem like trying conservative measures first (even if a waste of time)would be the first course of action and perhaps insurance might even dictate that path and then if that fails and one is a candidate for surgery it would be the next logical step. Then again guess it would depend on what the clinical picture is and if one is a candidate for surgery and if waiting might make any difference.

Hope your surgeon is open to discussing this with you even if he doesn't do this type of surgery and if he doesn't if he would have any recommendations for someone else that does (if you are a candidate).

IMHO, flat back is not a problem that needs to be fixed. It is an observation noting less than average lordoic and kyphotic curves in the spine. It is much like noting that fact that one may have a 'transitional segment'. This may represent one less or one more than 'normal' lumbar vertebrae. I believe it's something like 17% of the population that has a transitional segment. In some cases, there will be a malformation with the transitional segment that causes significant problems and must be fixed. However, in the huge majority of people with transitional segments, this finding is irrelevant.

I don't believe that flat back is a reason to have surgery and that in most cases, the risks of surgery will be much greater than the risk of issues caused by flat back. I have had clients who were world class athletes with flat back, and their spine problems are not related to their flat back.

Mark

Maria i did read DrPashmans info and also saw a video of another doc that was from Cedars discuss the syndrome.

Mark , my symptoms are very significant and getting worse. I cannot stand up straight, my knees must be bent. It causes my head to go forward even more than it does with my abnormal kyphosis in that area do to the brake. Everything i have read says there is great patient satisfaction with surgery. Patients wake up and can stand up painlessly again. WAlking is difficult as i end up within a few steps tipping forward and have to keep trying to right myself unsuccessfully every 4 or 5 steps. It is getting worse and now my upper back is always sore and i have been getting some jolting pain from my neck . Probably from being bent over so much.
The surgery would be hopefully to do an osteotomy or 2 in the straight lower back to create a curve which is entirely gone do to all the fusion i have.
Maybe your clients did not have symptoms ? I have to be able to walk up right if it is at all possible. I can't give up walking and cooking dinner and shopping for food. I know spend a lot of my day in bed. I need to get back to work too at some point .
judy

If you have flat back because of some serious structural issues, then fixing those issues may be important. In such a case, flat back is a symptom of another problem, not the problem.

Next time you are up for a dog beach run... bring films.

Mark

re dog beach
 

Hey guys..
I'm in town now so give me a heads up and hopefully Lola and I can make it as well to dog beach. We go pretty nearly there when hitting the Vet's in Seal Beach (boardering Bolsa Chica).

Mark i will get some films although none have been taken yet to diagnose this. Then i will bring them to you. I have no idea how to post them if i had them.!!
The info i googled for loss of lumbar lordosis lead me to the terms flat back syndrome. Is this incorrect?

Maria it would be so great to meet.
judy

I saw my spine surgeon yesterday. He told me there is no way he can do anything for me until my whole back has healed. Then and only then, he said he will take a standing picture of my spine to measure all the alignment. He did some measurements and found i do have some lumbar lordosis , but it is lower than he would like it to be. So i will just have to deal with all these symptoms and pain with pain pills as always. In January if my hip or probably any one other area is still bothering me he will do injections .

I may never get off pain pills !!
judy

re pain pills
 

Judy,
they aren't the worst thing in the world if one can function pretty good and get around most time w/o feeling mentally or physically impaired. Trust me..I know.

I think your surgeon sounds like the voice of reason re wanting to wait and give your body a proper chance at healing which you've not really done since you had the surgery!

Try to take it easy and still do what will best help you regarding your most recent fusion surgery.

I do hope you will progress and find yourself to be doing far better in the near future. Thanks for keeping us updated!!! Maria

For a while the pain meds were not making me sleepy, but they sure are now so that is why a life on them is scary. Feeling like a serious nap every 4 hours is debilitating and not really relieving the pain sucks too. But i have no choice at this point.
judy