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Flatback Syndrome, Spinal Surgery

Rebecca spine patient happy outside

Diagnosed with scoliosis at age 13, Rebecca Matthias is all too familiar with the finicky nature of a chronically troublesome back.

A decision was made to not correct the condition surgically, so it gradually worsened and eroded Rebecca’s quality of life until finally, with the birth of her second child, it was too much to bear. At 35, she had a procedure to correct her spine. And for the next 20 years, Rebecca found relief from the relentless pain that had come to define so much of her life.

About 10 years ago, it began creeping back. Unaware at the time, Rebecca had developed a condition called Flatback Syndrome, which afflicted some of those who had the Harrington rod implanted. Basically, because the stainless-steel device can’t follow the natural curve of the lower back, it straightens the spine into an unnatural position. Eventually, the affected discs begin to break down.

“By the time I was 60, the pain was chronic and difficult,” says Rebecca, who’s 65 now. “Daily activities were nearly impossible. Unless I was flat on my back, I was in pain.”

She and her husband, Dan, consulted doctor after doctor, but none of them could even tell her what was wrong with her, let alone how to treat her. It was Dan, through his own research, who suspected she may have Flatback Syndrome (which was later confirmed).

Vincent Arlet, MD, Chief of Adult Spinal Deformity Surgery at Penn Medicine, became Rebecca’s “one last shot.”

‘I was blown away’

“We met with Dr. Arlet, and he said he could fix my back,” Rebecca says. “He left the room and came back with a model of a spine. Then he showed me what he was going to do. He also showed me pictures of people with the same problem. I couldn’t stand up straight; I tilted forward. I was blown away. I signed up immediately. I was in so much pain, I had to do something.”

Rebecca had the surgery in December 2017.

“We have extensive experience in testing Flatback Syndrome here at Penn,” Dr. Arlet says. “In fact, over the last few years, we’ve developed a technique where we go in through the abdomen first, place a spacer, and then we implant the rods through the back. It seems aggressive, but it’s actually a more complicated and slower surgery to do everything from the back, which makes a big difference in the patient’s recovery.”

For the first two weeks after the surgery, Rebecca says she lived on her couch. “I didn’t want to take a chance with climbing the stairs,” she says. But within a month of the surgery, she was getting around more easily. And within four months, she was back to all of her normal activities.

‘It’s a whole different world’

Last June, six months after her surgery, Rebecca felt strong enough to manage a bike tour through France with her family.

“It’s night and day,” Rebecca says of the difference in how she feels today compared to before her surgery. “I’d pretty much given up on being anything more than what I was: an old person who couldn’t do much. It was a very bleak view of the future. But that’s gone now. I’m a very active person. I sit on a number of boards. I have a lot of hobbies. It’s a whole different world.”

Rebecca continues to work on her flexibility and range of motion for 10 to 15 minutes each morning.

“I’m making progress. After the surgery, I had difficulty tying my shoes and picking things up off the floor, but now I can,” she says. “My back is fused from the top to the bottom, so there was always going to be some limitation, but it’s so minor compared to how I was before the surgery.”

Rebecca’s posture was so distorted by her condition that she says she grew an inch-and-a-half as a result of the surgery.

“I don’t like to use the word ‘miracle’ with a scientific procedure, but that’s what this was,” she says. “Dr. Arlet gave me my life back.”

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