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What is adult degenerative spinal deformity? 

The human spine undergoes many changes as it ages. There is loss of bone density and strength. Discs become dehydrated and collapsed. Joints degenerate becoming larger and often incompetent. Muscles atrophy. Ultimately, all these degenerative processes result in global degeneration of the spine with a loss of lumbar lordosis, exaggeration of thoracic kyphosis, loss of cervical lordosis, possible vertebral slippage, and spinal scoliosis. This is experienced by a forward stooped poor posture with difficulty standing up straight. Patients afflicted with this are unable to stand or walk for any extended period without severe pain and disability. This severe pain can be present in the back or lower extremities. In addition, it can also be associated with weakness if nerves are compromised to a certain degree.  

Flat back syndrome and failed spine surgery

When spinal fusions are performed for degenerative spine conditions the common goals are to decompress the neural elements, stabilize and fuse the pain generating levels of the spine, and restore optimal biomechanical alignment to those levels of the spine.  Unfortunately, there are circumstances when, despite an excellent decompression of the nerves and successful spinal fusion, an ideal biomechanical alignment of the spine is not achieved. This may lead to persistent pain and disability characterized by an inability to stand or walk in a neutral upright posture for an extended period of time without severe pain. This may or may not be associated with incompletely fused levels, residual nerve compression, and/or new levels of degeneration above or below the previously treated levels. There is a temptation to simply extend the spinal fusion to the next levels. However, it is critical to optimize re-alignment of the spine in revision spine surgeries. 

Treatment for adult spinal deformity

Washington University Department of Neurosurgery Spine Deformity experts will provide you with a global and holistic assessment of the state of your spine including posture, alignment, fusion status, bone health, disc disease, spine joint disease, muscle health, nerve compromise, and general well-being to formulate a specific treatment non-surgical or surgical plan to restore your quality of life.