Fixed Sagittal Imbalance: Orthopedic Frisco

by Administrator 24. January 2017 19:44

Fixed Sagittal Imbalance (FSI) is a medical condition that affects the spine. Sagittal refers to the anteroposterior (front and back) view of the spine when observed from the side. The normal human spine has a slight curve which gives it an ‘S’ shape. The forward bend in the upper spine is called Kyphotic and the inward bend in the lower spine is called lordotic. These curves help in maintaining spinal balance besides positioning the center of gravity above the pelvis and hips. In some cases, either of the two curves may be exaggerated, causing the individual to bend either forward or backwards. This condition is termed as Fixed Sagittal Imbalance, implying that the sagittal balance is not correct and prohibits the individual from standing upright.

The condition can be categorized as follows:

  • Flatback Syndrome - In this case, the lower back loses the inward curve and the thoracic spine stands out prominently. This results in forward shifting of the center of gravity.
  • Kyphosis - It is characterized by an increase in the thoracic curve leading to the development of a hunch back


  • Osteoporosis- Weakening of the bones may affect spinal shape and stability
  • Surgical fusion of the lumbar vertebrae may result in FSI
  • Chronic Degenerative Disc Disease may result in loss of spine height and is a potential cause of Lordosis
  • Ankylosing Spondylitis is an inflammatory disease that makes the spine stiff and increases the risk for Kyphosis
  • Congenital defects in the spine
  • Direct trauma
  • Spinal implants such as rods used to correct problems like Scoliosis
  • Neuromuscular disorders such as Cerebral Palsy

Symptoms Of Fixed Sagittal Imbalance

  • Difficulty in standing straight
  • Daily activities may be hampered due to loss of balance
  • Shoulder and head may lunge forward
  • Hips may be pushed backwards while moving or standing
  • Abnormal gait
  • Pain may be felt in the lower back
  • Fatigue sets in easily
  • Numbness in the limbs as the spinal nerves may get stressed

Diagnosis Of Fixed Sagittal Imbalance

  • X-ray imaging to analyze the changes in the spine
  • MRI may be done to evaluate the soft tissue structures and degree of curvature
  • CT scans may be required to check for infections in the spine and get a detailed image of the anatomical structures
  • Physical examination may be conducted to assess the loss of function, change in gait and posture
  • The patient’s medical history may be taken into consideration to confirm the diagnosis

Treatment For Fixed Sagittal Imbalance

  • Osteotomy or surgical removal of a piece of bone to improve the flexibility of the spine
  • Spinal instrumentation- Surgery may be done to stabilize the spine using a bone graft and promote stability
  • Screws, rods and pins may be inserted surgically to hold the spine in correct position. This is called spinal fixation
  • Physical therapy may be recommended post-surgery to help the patient regain spine movement and flexibility as well as strengthen the supporting muscles.

For treatment of Fixed Sagittal Imbalance, visit OrthoTexas, Frisco. To schedule an appointment with the spine specialists, you can call at (214) 618 - 5502.

Tags: ,