Straight Back Syndrome of Mine

Straight Back Syndrome of Mine

 

This description has no relationship to the medical conditions stated below.

Fortunately my initial are also S.B. and I am known to be a genetically predisposed be having a straight back aggravated by my early childhood sports activities.

It started to dawn on me that, I have had several minor spinal stress fractures.

They started affecting me in my internship.

As a kid I could touch my toes with hands by bending (while keeping the back straight).

I have long legs particularly suitable for short distance running and jumping.

I noticed that I was losing this ability gradually while in the university.

I did lot of long jump and hop step and jump as part of my training ending with military drill around the university track daily.

I never practiced short distance running in the track.

I did that with my dog around the lake of Kandy.

My dog was my trainer.

I could never beat him and I had the leash to restrain him when I needed to catch my breath and rest.

On the days (over the weekend) I wasn't in the campus, I did my running with the dog. My dog was perfect companion and sporting match and wizard. Unfortunately, dog died tragically when I went away for my internship. I should have taken him with me.

I won't tell you the story, I was told about its death.

I still believe it was cooked up story to pacify my anger.

He died due to his separation from its dearly loved master companion.

There was nobody to take him round the lake.

I did not have a dog for nearly 25 years after this episode.

My campus dog (called the lone ranger) and roommate of course lasted the full life cycle since I handed over the dog to Nicholus Uncle who was our physiology technician.

He was there even when I returned from UK, in good condition.

My Straight Back Syndrome started affecting me in my internship with constant back pain. I did not give up sporting activity but continued on badminton and table tennis and never running and long jump.

Over time with heat treatment (we did not have warm hydrotherapy) and constant alert and avoidance of further damage, I was without pain in about four years.

But my back became straight and I cannot touch my toes as I used to do as a kid.

This gave me an added advantage and good stead. 

I never bend down even to a politician. 

Also I never go with bended knees like an average Sri-Lanka. 

When, I went abroad, it was very useful.

All Asians, who are vociferous in front of the local voters go bended back and knees when in Western countries. 

I always kept my back straight in front of white men well over 6 foot 6 inches and most of them thought, I was smart and I never told anybody, I had a stiff back probably due to spinal fractures or the straight back syndrome. 

 But I regularly went for hydrotherapy which was available free in hospitals, there. Now my back does not bend to even monks of BBS. leave alone, the politicians. Below are medical explanations.

Flat Back Syndrome

Spinal Curvatures

The human spine has natural curvatures.

When you look at a back from behind, the spine should be straight and centered over the pelvis. However, when you look at the spine from the side, the curves are designed to maintain balance as the spine is behind organs in the chest and abdomen.

The spine has two alternating curves to create an “S” like shape.

In the neck and low back there is normally an inward curvature or sway back known as lordosis.

In the thoracic spine and sacrum there is an outward curvature known has kyphosis or hunchback. These curves normally balance out each other so that when the patient stands they are well balanced with their head straight above their hips when viewed from the side.

Standing in this position minimizes the effect of gravity and allows the patient to stand with the best posture and use the least energy when moving or walking.

Flat back syndrome is an abnormal condition where the spine loses its natural low back curve to become flat. The spine becomes imbalanced and the patient leans forward. Patients with flat back syndrome typically notice troubles standing upright or have ongoing back or leg pain. Symptoms usually worsen as the day goes on and the patient feels they lean further and further forward the longer they try to stand upright. The severity of the symptoms usually depends on the amount of curvature present and difficulties with standing erect.

In patients with flat back syndrome, a loss of normal lumbar curvature causes an imbalance of the spine. The patient’s head begins to lean forward, away from the body and they may have trouble standing upright.
This imbalance can cause muscle fatigue and pain.

Today, the term flat back syndrome has been broadened to include any patient with a decrease in lumbar lordosis causing symptoms.

As such, flat back syndrome can occur as a result of any condition that shortens the front portion of the spine, causing the patient to lean forward.

Flat back syndrome may develop as the result of the following causes:

Degenerative Disc Disease,

Lumbar Post Laminectomy Syndrome,

Compression Fractures,

Ankylosing Spondylolitis.

Degenerative Disc Disease:

For some patients, progressive degeneration of the intervertebral discs or the shock absorbers of the spine may lead to a loss of height in the front part of the spine. As discs degenerate the spine begins to lean forward and lumbar lordosis decreases.

The patient may develop pain as a result of the degenerative disc disease or as a result of the spinal imbalance.

Lumbar Post Laminectomy Syndrome:

Lumbar flat back syndrome may develop in patients previously treated with a laminectomy or other lumbar surgery to decompress the spinal nerves to treat stenosis.

These procedures can lead to a decrease in lumbar lordosis and in some cases spinal instability.

Vertebral Compression Fractures:

Compression fractures are often the result of weak spinal bones due to osteoporosis. A fracture can lead to loss of height of the bone in the thoracic and lumbar spine. This may occur in one bone or in multiple bones throughout the spine, resulting in flat back syndrome.

Ankylosing Spondylitis:

Ankylosing spondylitis (AS) is a chronic inflammatory disease that causes stiffness and arthritis throughout the entire spine. Some patients with AS notice an increasing forward posture of the spine, including an increase in thoracic kyphosis or decrease in lumbar lordosis.

This can lead to symptoms of lumbar flat back syndrome.

Straight back syndrome (SBS)

Straight back syndrome (SBS) is a thoracic deformity characterized by loss of the normal upper thoracic spinal kyphosis. This deformity leads to a reduced antero-posterior diameter of the chest causing a compression or “pancaking” of the heart and great vessels so as to appear enlarged. This is accompanied by a leftward displacement of the heart, resulting in cardiac murmurs¹, chest pain and tracheal compression^.

Mitral valve prolapse (MVP) has been reported in 64% of patients.

Misdiagnosis of straight back syndrome as pericardial absence has also been cited.

A study investigating the relationship between SBS and MVP showed echocardiograms to be normal in 36% of patients diagnosed with SBS; however, 58% of these patients demonstrated mitral valve prolapsed.

Despite the fact that this syndrome has been recognized for over 50 years, it is not commonly considered as a differential diagnose and thus the incidence is unknown.

However, given that this syndrome is often associated with heart symptoms, it is important that health care practitioners are made aware of SBS and consider it as a differential diagnosis in a patient presenting with symptoms that can appear to be cardiac in nature.

This is especially true in cases of atrial septal defect which can resemble the symptom picture of SBS.