Something to think about

[Guest guest]

The entire question of why one person gets flatback and another does not is quite perplexing. I am glad you are asking the entire group this question as we are such a diverse group but the answer just might lie somewhere within our ranks. Something that the surgeons out there should also be looking at so that they can prevent this syndrome from happening to anyone else.

I was fused in 1977 with bone from my right hip with a harrington distraction rod implanted at the same time. I was 17 years old. I developed my curve when I was 15 / 16 years old. The doctors explained the procedure as hooking the rod to the vertebrae above and below the curve and using a little "jack" to straighten it out as much as possible. I am fused from T4 to L3 and went from a curve of around 50 degrees to about 13.

One issue that I also recall being talked about was that I had significant lordosis prior to the surgery. After surgery, I stood very straight and from the front and back I looked pretty normal. I was able to dress like anyone else and most people didn't notice anything other than I had impressive posture.

I, too, pretty much forgot about the surgery and went on my way for 30 years. I had some issues that reminded me time to time of my surgery, a dropped shoulder on the right (I was curved to the right and that shoulder was higher prior to surgery), not being able to sit on the floor for any length of time - my lower back would sort of lock up, and had muscle spasms in my shoulders and neck from time to time.

My current pain started about 4 years ago while shoveling heavy, wet, snow. I pushed myself too far and ended up with a backache like no other that lasted for over a month. It gradually subsided and I seemed okay for about a year. Then while on vacation in the summer of 2008 my back started hurting terribly while we were hiking and walking and worsened over several days to where I really thought I'd have to go to the emergency room. We made it back home (we were driving) and when I went to the doctor they gave me a prednisone pack which helped a little. But I never completely recovered.

By late February of 2009 I was having excruciating pain, could not walk more than 5 minutes without having to sit to relieve the pain. I could still stand up straight, although when in pain like that you tend to lean forward to relieve it. It turned out that I had developed a synovial cyst at my L4/L5 level. I was able to get the cyst ruptured in May of 2009 and I have not had a return of that terrible pain. However, I still have lower back pain that comes and goes in it's severity but I can mostly manage it without pain medication, so it ain't that bad.

I am limited in what I can do these days because too much standing or vacuuming or gardening will set off the pain - so I try to be careful. Otherwise, I still stand straight, I look "normal" other than from the rear. My spine looks like it is deep in the center of my back, like a crease between my shoulder blades and it gradually comes back out just above my rear end. My shoulder blades stick out like wings. I ride an exercise bike and walk on a treadmill (set at a slightly upward angle so that I lean forward to walk) at home for exercise. I am still somewhat flexible and can touch my toes from a straight leg standing bend after stretching a bit. Swimming makes my lower back ache as the arching one does while swimming is uncomfortable at times. I maintained a decent weight even during my three pregnancies. I was able to deliver all three without a C section. I did have back pain during my pregnancies, but nothing major.

I sometimes think that I did/do have more lordosis than the average person and maybe that is what has allowed me to not develop flatback, at least not to the extent that many here have it. My surgeon told me I have "early" flatback but when I read what others here have endured, I do not really fit into that category. Mostly, the CT Myelogram I had in 2009 showed some arthritic changes in my facet joints and mild bulging of the discs below my fusion, and I still have acceptable lordosis in my lower 3 vertebrae. X-rays indicate that my curve has not changed. So I have no major issues except the cyst, but I do have some degree of back pain 24/7, it just varies from mild too fairly bad but I can ease it with stretching and laying flat on my back with knees bent, sometimes I take over the counter arthritis medicine. I also have joint pain (they say it's osteoarthritis) in my feet, hands, knees, hips and shoulders - sometimes I feel like I'm 80 years old!

So, I don't know how this relates to the experiences that others here have had, but I would be very interested to hear if anyone can relate to my particular set of issues.

I am going to keep track of any responses to see where each individual was fused and to what extent they developed flatback or other problems. Just to see what this little research project shows.

Jeanne

Something to think about

Jeanne brought up an interesting point in her reply to ...why ARE there some scoliosis patients, who had the typical Harrington rod procedure of the 60's and 70's, who experience no problems later in life? I'm assuming that the fusion and rod insertion surgical procedures were basically similar from hospital to hospital, surgeon to surgeon. So why do some of us develop Flatback Syndrome while others do not?I had never really given it much thought before I read 's post but now I can't STOP trying to figure out the WHY?? Here I go again, harping on my favorite theme that the only stupid questions are the ones not asked!! So here's a question for the group: How many with thoracic ONLY (anywhere from T1 through T12) rod/s and fusions have developed Flatback Syndrome? How many with thoraco-lumbar fusions (T10 through L5)? How many with lumbar ONLY (T12 through L5) fusions? I fit into the thoraco-lumbar group; my original fusion in 1970 was T11 through L4. As I've mentioned in other posts, I herniated L5 in 1985, either during my pregnancy or while trying for a vaginal delivery. The symptoms of Flatback ( first, pain in lower back and left leg; then difficulty standing up straight) did not become evident to me until 1995. Until then, I had a pretty normal life...happily married with 2 children (older son is my "bonus son"; all the joy of being a co- Mom without the pain!!), worked full time, did all the PTA & sports stuff with my boys...a full and wonderful life. Then WHAM!!! I got knocked on my tush by something called Flatback related to a surgical procedure I usually forgot I'd ever had!!! Talk about not fair!!??The surgeon who performed my revision procedures told me that my Flatback was due to the fact that Harrington rods are distraction rods (I always called it my internal car jack!) and that the old methods flattened the spine out. Back then, apparently no thought was given to the fact that, in my case, they "flattened out" any normal lordosis. I had never wondered 'why?' I didn't look like other women in jeans with a shirt tucked in. I wore scrubs at work for over 25 years, was never much of a clothes-horse, HATE shopping, and have 2 boys and a husband! Our idea of a perfect family outing is going to dirt track stock car races on Sat.nite and eat hot dogs covered in dirt!! Who had the time or the inclination to pay attention to things like whether my neighbor looked better in a pair of Calvin Klines?? I wore Levi's!!I'd love to hear from others as to what levels their original fusions were; those with and without symptoms of Flatback Syndrome. How much about this deformity is mechanical? Was there a difference in the surgical procedures or length of time in casts/braces post-op? I'm really curious now!All the best,Beth