78 year old patient who can’t walk more than 70 feet without upper LB ache that stops her but pain will go away with sitting or lying down.

1. Clinical Case Studies

2. 78 yo Patient who can’t walk
more than 70 feet without upper
LB ache that stops her
• Note flexed forward
posture
• Bent knee stance
• Hypo-lordotic lumbar spine
• Pain gone with sitting and
lying down
• What 6 things cause this
deformity?

3. Flat Back Posturing
• Antalgia secondary to central stenosis.
LRS, FS
• Lumbar Degenerative Disc Disease with
loss of lordosis (can’t straighten due to
loss of lumbar lordosis-flat back
syndrome)
• Facet pain/spondylolisthesis (rare)
• Thoracic hyperkyphosis with poor
lumbar compensatory mechanism
• Hip, knee flexion contractures,
• Hamstring and gluteal weakness (L5
and S1)

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