Flatback Syndrome
Houston Methodist spine specialists diagnose and treat flatback syndrome, a spinal deformity that affects posture and overall alignment. Flatback syndrome is often discussed alongside conditions such as scoliosis or kyphosis because each affects how the spine supports the body. The goal of treatment is to identify what’s causing the imbalance and develop a plan that helps you stand, walk and move more comfortably.
Our spine experts work as a team to recommend a personalized treatment plan based on your symptoms, health and goals. When appropriate, eligible patients may also have access to clinical trials studying innovative approaches to spine care.
What Is Flatback Syndrome?
Flatback syndrome is a spinal deformity in which the lower spine loses its natural inward curve (lordosis).
As that curve flattens, the body may lean forward (sometimes called sagittal imbalance), making it harder to stand upright without fatigue or pain. Unlike scoliosis, which curves the spine side to side, flatback syndrome primarily affects the spine’s front to back alignment.
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Why Choose Houston Methodist for Flatback Care?
If flatback syndrome affects your daily life, you need answers and a plan that helps you move forward. Houston Methodist spine specialists and neurosurgeons offer advanced evaluation and a full range of treatments for flatback syndrome — from non-surgical care to complex spine surgery.
As one of Texas’ top-ranked spine programs, our team includes orthopedic spine surgeons and neurosurgeons who personalize your care plan, including coordination across specialties, advanced imaging and, when appropriate, access to clinical trials studying new therapies. Above all, our goal is to reduce symptoms, restore function and help you get back to doing what you enjoy.
Common Causes of Flatback Syndrome
There are many possible causes of flatback syndrome. While flatback syndrome is often associated with prior spine surgery, it can also develop over time due to degenerative changes or other spine conditions.
Common causes include:
- Previous spinal fusion surgery– a flat fusion or issues with instrumentation
- Degenerative disk disease – age-related wear that affects the spine’s cushioning
- Ankylosing spondylitis – inflammatory arthritis of the spine
- Osteoporosis and compression fractures
- Neuromuscular conditions
- Prior Harrington rod surgery for scoliosis (in some patients) may be associated with later flatback syndrome in some people
Signs & Symptoms of Flatback Syndrome
People with flatback syndrome often notice they feel more comfortable leaning forward or sitting than standing upright, and that standing or walking becomes more tiring as the day goes on.
Recognizing symptoms early can help your doctor diagnose flatback syndrome and recommend treatment to improve posture and function.
If the condition progresses, it may contribute to chronic pain and difficulty standing upright. Early evaluation can also help identify related issues that sometimes occur alongside spinal imbalance, such as spinal stenosis or sciatica.
Posture Changes
Lower Back Pain
Persistent lower back pain is common and may become severe.
Difficulty Walking
Spinal imbalance can affect mobility and make walking more difficult. Some people may eventually need a mobility aid for stability or comfort.
Fatigue
Because your muscles may work harder to help you stay upright, fatigue (extreme tiredness) or malaise (feeling unwell or uncomfortable) can build throughout the day. Symptoms may feel worse later in the day.
How Flatback Syndrome Is Diagnosed
Because flatback syndrome affects overall spinal alignment, evaluating global spinal balance is an important part of diagnosis. Diagnosis starts with your medical history and physical exams. Your doctor may use imaging tests to assess spinal alignment, confirm a diagnosis and help guide treatment planning.
Your doctor may use one or more of the following tests:
- X-ray – uses a small dose of radiation to evaluate spinal alignment and curvature loss; full-length standing films may be used to assess overall balance
- Magnetic resonance imaging (MRI) – uses magnets and radio waves to visualize soft tissue structures, including disks, nerves and the spinal cord
- Computed tomography (CT) scan or CT myelogram – creates detailed cross-sectional images to evaluate bone structures and, when needed, bone quality.
Convenient Spine Care Locations Across the Greater Houston Area
Across Houston, our patients have access to our expert neck, back and spine specialists so that you can get the best possible care personalized for your needs — without traveling far from home. Explore our footprint of locations in the Greater Houston area and suburbs below.
