Flatback syndrome

Mechanism and manifestations

A person may bend the knees or rotate the pelvis backward to maintain balance. Fatigue and pain can occur; prior surgery, degeneration or other causes may contribute.

Diagnosis and management

Standing whole-spine and pelvic radiographs assess compensation. Rehabilitation and treatment of contributing causes are individualized; disabling deformity may require surgical assessment. A posture photograph does not establish the syndrome.

Points to consider

Deformity assessment considers age, remaining growth, global balance and symptoms. Images must be interpreted in light of acquisition position. Goals may include function and comfort, limiting progression or neurological protection, depending on the situation.

Role of TAGMED care

At TAGMED, assessment aims to understand symptoms, history and functional limitations. Manual care and osteopathy, motorized spinal decompression, laser and shockwave have different indications. The term described in this entry is not enough to select any of these modalities. Their relevance, limitations and possible contraindications should be discussed in relation to diagnosis and individual goals.

Related concepts and distinctions

These concepts belong to the same field, but are not synonyms.

• Hyperkyphosis — Excessive posterior-convex spinal curvature, usually thoracic, which may be postural or structural.
• Spondyloptosis — Extreme vertebral slippage in which one vertebra has moved completely beyond the endplate of the vertebra below.
• Degenerative scoliosis — Adult scoliotic deformity related to asymmetric disc and joint degeneration, sometimes developing after skeletal maturity.

Medical references

1. Scoliosis Research Society. Kyphosis.
2. Scoliosis Research Society. Scoliosis.

References document the topic; their inclusion does not imply endorsement of TAGMED services by those organizations.