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Spine Surgery Guide

Flatback Syndrome

Flatback Syndrome

The spine has two curves, which helps it carry the weight of the trunk, arms and neck in a balanced way. The spine curves slightly backwards where it joins the pelvis. This curve is called lordosis. At chest level where the ribs join the spine, it curves slightly forward. This curve is called kyphosis.
Flatback syndrome occurs when there is a loss either of lordosis or kyphosis or both, making the spine straight. Persons with flatback syndrome appear stooped forward and often have difficulty standing up straight.

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In addition to the appearance of their backs, persons with flatback syndrome may also have:
  • A sensation of falling forward
  • Chronic pain in the back muscles
  • Difficulty with certain daily activities
  • Fatigue
  • Stooping at the end of the day

Many patients with a significant flatback deformity require a cane or a walker to assist them when walking because they are stooped forward and their weight is not centered over their pelvis and legs. The condition can be a source of significant pain, disability and frustration.
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Causes and Risk Factors

Flatback syndrome sometimes occurs after scoliosis has been corrected. The rods used to straighten the abnormal curve of the scoliosis tend to also straighten out the normal curves of the back. The condition can also result from arthritis of the spine or spinal fusion surgery.


A diagnosis is based on the patient's medical history and a physical examination.

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In the past, flatback was associated with spine surgery to correct the side-to-side curves of scoliosis or to fuse bones. Today surgeons are often able to correct scoliosis while keeping as much as possible of the normal curves of the spine.

Treatment options will depend on the causes and degree of the flatback syndrome present in a patient. Persons with this condition should consult with specialists who are expert in treating spinal deformities in adults.
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This information is not designed to replace a physician's independent judgment about the appropriateness or risks of a procedure for a given patient.
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