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Flat Back Syndrome

- Discussion:
    - results from arthrodesis w/ distraction involving lower lumbar spine;
    - young patients can compensate via flexion of hips & knees;
    - adults > 40 years loss ability to compensate & go on to develop fatigue-like pain along w/ a stooped posture;
- Prevention:
    - operations on lumbar spine must preserve lumbar lordosis;
- Treatment after Deformity Occurs:
    - anterior opening wedge osteotomy along w/ posterior closing-wedge osteotomy to restore lordosis