Flatback Case 1

Case Review #1: 48 year old Female with Flatback Syndrome from Robert Pashman

A 48 year old female presented one year after scoliosis surgery. The patient was decompensated forward, had back pain, leg pain, and was diagnosed with flat back syndrome. Dr. Pashman treated her with revision surgery. He performed a posterior fusion T12-L5.

    Case Review:

    Flatback Syndrome treated with ASF/PSF Robert S. Pashman, MDScoliosis and Spinal Deformity Surgery

    Patient History:

    Flatback Syndrome 48 year old female with Adult Idiopathic Scoliosis 1 year status post Anterior/Posterior Spinal Fusion to correct 60° thoracolumbar-lumbar curvature Progressive decompensation forward Low back pain Failed conservative therapy

    Pre-Operative X-Rays:

    The patient presented with low back and leg pain. Patient is decompensated forward as shown with plumbline. There is also decreased lumbar lordosis. Pre-op Pre-Flatback correction surgery

    Surgical Strategy:

    Kyphectomy L3 Laminectomy L3, subtotal laminectomy L2 and L4 Decancellation osteotomy, pedicle subtraction osteotomy L3• Spinal instrumentation T12-L5 Posterior lateral intertransverse fusion T12-L5


    Sagittal balance was corrected. Lumbar lordosis was induced. The patient now plumb line’s perfectly. The patient’s symptoms were resolved.