Loss of lumbar lordosis (LL) after scoliosis or lower lumbar distraction instrumentation, vertebral fracture, ankylosing spondylitis, or degenerative disease
Sagittal imbalance with center of gravity of head anterior to sacrum
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Reporting Tips
Selected References
Janjua MB et al: Surgical treatment of flat back syndrome with anterior hyperlordotic cages. Oper Neurosurg (Hagerstown). 18(3):261-70, 2020
Chou D et al: The mini-open pedicle subtraction osteotomy for flat-back syndrome and kyphosis correction: operative technique. Oper Neurosurg (Hagerstown). 12(4):309-16, 2016
Boissière L et al: Lumbo-pelvic related indexes: impact on adult spinal deformity surgery. Eur Spine J. 24(6):1212-8, 2014
Vital JM et al: Osteotomies through a fusion mass in the lumbar spine. Eur Spine J. 1:S107-11, 2014
Weisz GM et al: Scanogram for sagittal imbalance of the spine: low dose alternative for a safer diagnosis. Curr Rheumatol Rev. 10(1):35-7, 2014
Hedlund R: Pedicle subtraction osteotomy in flat back syndrome 38 years after Harrington instrumentation for AIS. Eur Spine J. 21(3):563-5, 2012
Potter BK et al: Prevention and management of iatrogenic flatback deformity. J Bone Joint Surg Am. 86-A(8):1793-808, 2004
Wiggins GC et al: Management of iatrogenic flat-back syndrome. Neurosurg Focus. 15(3):E8, 2003
Danisa OA et al: Surgical correction of lumbar kyphotic deformity: posterior reduction "eggshell" osteotomy. J Neurosurg. 92(1 Suppl):50-6, 2000
Umehara S et al: The biomechanical effect of postoperative hypolordosis in instrumented lumbar fusion on instrumented and adjacent spinal segments. Spine (Phila Pa 1976). 25(13):1617-24, 2000
Booth KC et al: Complications and predictive factors for the successful treatment of flatback deformity (fixed sagittal imbalance). Spine (Phila Pa 1976). 24(16):1712-20, 1999
Lin RM et al: Lumbar lordosis: normal adults. J Formos Med Assoc. 91(3):329-33, 1992
La Grone MO: Loss of lumbar lordosis. A complication of spinal fusion for scoliosis. Orthop Clin North Am. 19(2):383-93, 1988
Loss of lumbar lordosis (LL) after scoliosis or lower lumbar distraction instrumentation, vertebral fracture, ankylosing spondylitis, or degenerative disease
Sagittal imbalance with center of gravity of head anterior to sacrum
IMAGING
General Features
Radiographic Findings
CT Findings
MR Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
CLINICAL ISSUES
Presentation
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Reporting Tips
Selected References
Janjua MB et al: Surgical treatment of flat back syndrome with anterior hyperlordotic cages. Oper Neurosurg (Hagerstown). 18(3):261-70, 2020
Chou D et al: The mini-open pedicle subtraction osteotomy for flat-back syndrome and kyphosis correction: operative technique. Oper Neurosurg (Hagerstown). 12(4):309-16, 2016
Boissière L et al: Lumbo-pelvic related indexes: impact on adult spinal deformity surgery. Eur Spine J. 24(6):1212-8, 2014
Vital JM et al: Osteotomies through a fusion mass in the lumbar spine. Eur Spine J. 1:S107-11, 2014
Weisz GM et al: Scanogram for sagittal imbalance of the spine: low dose alternative for a safer diagnosis. Curr Rheumatol Rev. 10(1):35-7, 2014
Hedlund R: Pedicle subtraction osteotomy in flat back syndrome 38 years after Harrington instrumentation for AIS. Eur Spine J. 21(3):563-5, 2012
Potter BK et al: Prevention and management of iatrogenic flatback deformity. J Bone Joint Surg Am. 86-A(8):1793-808, 2004
Wiggins GC et al: Management of iatrogenic flat-back syndrome. Neurosurg Focus. 15(3):E8, 2003
Danisa OA et al: Surgical correction of lumbar kyphotic deformity: posterior reduction "eggshell" osteotomy. J Neurosurg. 92(1 Suppl):50-6, 2000
Umehara S et al: The biomechanical effect of postoperative hypolordosis in instrumented lumbar fusion on instrumented and adjacent spinal segments. Spine (Phila Pa 1976). 25(13):1617-24, 2000
Booth KC et al: Complications and predictive factors for the successful treatment of flatback deformity (fixed sagittal imbalance). Spine (Phila Pa 1976). 24(16):1712-20, 1999
Lin RM et al: Lumbar lordosis: normal adults. J Formos Med Assoc. 91(3):329-33, 1992
La Grone MO: Loss of lumbar lordosis. A complication of spinal fusion for scoliosis. Orthop Clin North Am. 19(2):383-93, 1988
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