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Musculoskeletal13 papers

Straight back syndrome

Last edited: 4/15/2026

Overview

Straight back syndrome, also referred to as flat back syndrome, is a complication often seen following spinal surgeries, particularly those for spondylolisthesis, characterized by loss of lumbar lordosis, postural changes, and associated pain 2.

Diagnosis

  • Imaging findings indicative of loss of lumbar lordosis and postural abnormalities 2.
  • Clinical presentation includes back pain, postural changes, and potential neurological deficits 12.
  • Epidural compressive lesions identified via MRI or CT myelography may suggest complications like misplaced grafts 1.
  • Management

  • Surgical intervention, often requiring combined anterior and posterior approaches, for severe cases 2.
  • Removal of compressive epidural masses, such as misplaced fat grafts, may be necessary 1.
  • Physical therapy and conservative management may be considered for milder symptoms 2.
  • Special Populations

  • No specific guidance provided for pregnancy, pediatrics, or elderly populations in the given abstracts [].
  • Comorbidities like previous spinal surgeries increase risk and complexity of management 12.
  • Key Recommendations

  • Consider combined anterior and posterior surgical approaches for managing straight back syndrome secondary to previous spinal surgeries 2 (Evidence: Moderate).
  • Evaluate and surgically address compressive epidural lesions, such as misplaced fat grafts, to alleviate symptoms 1 (Evidence: Weak).
  • Conservative management including physical therapy should be considered for less severe cases 2 (Evidence: Moderate).
  • References

    1 Israel Z, Constantini S. Compressive epidural autologous free fat graft in a patient with failed back syndrome: case report. Journal of spinal disorders 1995. link 2 Bradford DS. Failed back syndrome secondary to previous spondylolisthesis surgery. La Chirurgia degli organi di movimento 1994. link

    Original source

    1. [1]
    2. [2]
      Failed back syndrome secondary to previous spondylolisthesis surgery.Bradford DS La Chirurgia degli organi di movimento (1994)

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