I am a second-generation Asian American. My grandmother lives with us and needs surgery for her back. After years of working in a stooped position, she can no longer stand up straight. The surgeon is going to fuse her lower back from the front and the back. How does this help the problem of being stooped over?

Your grandmother may have a condition called lumbar degenerative kyphosis or flat back syndrome. This is one of the most common spinal deformities in Asia.

It appears to occur most often in middle-aged and older Asian women. Lifestyle and working postures likely contribute to this condition. Sleeping on the floor and eating and working in a crouched position are the main risk factors.

Studies show that surgery to fuse the lumbar spine results in a spontaneous correction of the curves in the thoracic (midback) spine. The studies were specifically of Asian patients with flat back syndrome.

Combining an anterior (from the front) and posterior (from the back) fusion procedure gives the best result. The surgeon is able to regain maximum lordosis in the lumbar spine with this approach. Lordosis refers to the natural swayback position of the lower spine.

In order to achieve this affect, the anterior spinal column is lengthened. At the same time, the posterior spinal column must be shortened. The patient benefits by the results: less pain and improved function and posture.

Reference: 

Jee-Soo Jang, MD, PhD, et al. Changes in sagittal alignment after restoration of lower lumbar lordosis in patients with degenerative flat back syndrome. In Journal of Neurosurgery: Spine. October 2007. Vol. 7. No. 4. Pp. 387-392.


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