Risk Factors
How We Can Help You for Flat Back/Sagittal Imbalance
The doctors in the Stanford Medicine Spine Center have the experience needed to effectively treat flat back/sagittal imbalance syndrome, also known as sagittal imbalance.
We help relieve symptoms, which most commonly include pitching forward of the upper body and head. We also provide relief for symptoms such as back pain and leg pain. Our team always emphasizes the least invasive treatment approaches possible but also excels at the most complex surgical procedures, when needed.
Stanford Medicine Spine Center patients with flat back/sagittal imbalance also may have opportunities to participate in research studies of new treatment approaches not yet available anywhere else.
What We Offer You for Flat Back/Sagittal Imbalance
- Center of Excellence for advanced care of all spine-related conditions.
- Nationally recognized expertise in treating all types of flat back/sagittal imbalance syndrome, no matter how complex.
- Precise diagnosis options including the latest imaging technology.
- Team-based treatment planning that brings together orthopaedic surgeons, neurologists and neurosurgeons, pain management specialists, rheumatologists, physiatrists, and others to tailor care to your needs.
- Advanced treatment options emphasizing noninvasive approaches whenever possible, including exercises, physical therapy, and medication therapy, and, when needed, spine surgery.
- Comprehensive support services including care coordination from diagnosis to treatment to follow-up.
- Active research program to develop new diagnostic and treatment advances.
Treatments for Flat Back/Sagittal Imbalance
The team members of the Stanford Medicine Spine Center use the most advanced techniques to effectively treat flat back/sagittal imbalance syndrome. We have experience with all treatment approaches and emphasize minimally invasive techniques whenever possible.
Our team includes doctors from orthopaedics, neurology, neurosurgery, rheumatology, physiatry, and other specialties, working together to help ensure you receive an accurate diagnosis and the most effective treatment possible.
The causes of flat back vary from person to person, so we customize a treatment plan to each individual’s unique condition.
Choosing the most effective treatment
Our treatments focus on:
- Restoring proper balance
- Relieving pain and other symptoms
- Keeping your condition from getting worse
- Helping you continue or resume doing your daily activities
Emphasizing minimally invasive options
Early, precise diagnosis and treatment are key to timely care and prompt relief of symptoms.
Our team always emphasizes nonsurgical treatment. Whenever appropriate, we recommend:
- Braces
- Walking aids, such as a cane or walker
- Physical therapy
- Medication
- Lifestyle changes, including weight reduction and smoking cessation
The choice of treatment depends on:
- Your age, medical history, and current health status
- The severity of your condition
- The projected future course of your condition
- Your tolerance for medications and other treatment options
- Your personal preferences
Surgical treatment, when needed
When surgery is the best option, we perform the most advanced procedures designed to help correct the imbalance in the back and control pain:
- Osteotomy: Your doctor also may refer to this procedure as “posterior column osteotomy” or PCO. The surgeon removes a wedge-shaped section of bones at the back of the spine. To compensate for the change that will result, the surgeon also usually removes a disc in front of the wedge. Then, the closing of the wedge can help correct the balance in your back. In some cases, your doctor may recommend a series of these procedures in different locations on the spine to achieve the desired correction.
- Spinal fixation: The surgeon inserts metal screws and rods to hold the rebalanced spine in its proper position.
- Spinal fusion: The surgeon inserts new pieces of bone that grow together (fuse) to add strength and stability to the rebalanced spine.
Clinical Trials
Clinical trials are research studies that evaluate a new medical approach, device, drug, or other treatment. As a Stanford Health Care patient, you may have access to the latest clinical trials.
Open trials refer to studies that are currently recruiting participants or that may recruit participants in the near future.
What Is Flat Back/Sagittal Imbalance?
The normal spine has two curved shapes:
- Lordosis: the inward curve in the lumbar (lower) spine
- Kyphosis: the outward curve in the thoracic (middle) spine
These two curves work together to keep your center of gravity right where it should be—over your hips and pelvis.
However, when a person has flat back/sagittal imbalance, deformity causes the torso and head to pitch forward toward the pelvis.
Our Clinics
The Stanford Medicine Spine Center is staffed by world-class spine specialists from neurosurgery and orthopaedics, who work together to offer you the world’s most advanced and effective treatment options—including those that don’t involve surgery. Our goal is to safely get you back to your normal lifestyle as soon as possible, and maintain long-term spinal health.
To schedule an appointment, please call 650-725-1125.