Join Our Members

Flatback Syndrome

The most common cause is the use of distraction instrumentation such as a Harrington rod, in the lumbar spine. Obviously, the patients who have the most severe flat-back syndrome will be those who have had distraction instrumentation placed all the way down to the sacrum. Occasionally doctors will see patients who have thoracolumbar kyphosis-a deformity above the lumbar area which would aggravate the forward positioning of the spine and cause flat-back syndrome.

But far and away the most common etiological factor would be the use of distraction instrumentation in the lumbar spine.

Most-but not all-spine surgeons now know that this is something you don't do. In the early days of Scoliosis surgery, surgeons were more concerned with the frontal plane of the deformity and were not as aware of the sagittal or lateral plane, and over time they began to see patients presenting with these problems. It soon became apparent that the sagittal plane was just as important as the frontal, and they realized the importance of not using distraction instrumentation in the lumbar spine. As a result, the incidence of flat-back syndrome has diminished, but it is still seen.