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A fixed sagittal imbalance is characterized by the loss of the natural forward and backward curvature of the spine. This imbalance sets off the body’s natural posture and makes it more difficult to maintain stability. A fixed sagittal imbalance may also make it more difficult to complete everyday tasks like standing up and walking around. When the body’s natural balance is offset, it requires more energy and effort to maintain posture and move around. Fixed sagittal imbalance also tends to make patients appear older than they are. 

There are two variations of fixed sagittal imbalance: type I and type II. Type I is referred to as compensated deformity. The patient can maintain balance if they overextend and bend the spine back to compensate for the fixed vertebrae segments. Type II is called decompensated deformity. In this type, there are not enough segments that are unfixed to counteract the fixed segments. This makes it difficult for the patient to maintain balance.


The most common symptom of fixed sagittal imbalance is a visible loss of curvature in the spine.

Other symptoms of fixed sagittal imbalance include:

  • Difficulty completing everyday tasks
  • Feeling of leaning forward
  • Lower Back pain
  • Pain that radiates down the legs
  • Trouble walking
  • Fatigue


Many cases of fixed sagittal imbalance are caused by previous surgeries on the spine.

The causes of fixed sagittal imbalance include:

  • Osteoporosis
  • Degenerative disc disease
  • Ankylosing spondylitis
  • Extensive lumbar fusion

If you are having trouble balancing, it could be a result of fixed sagittal imbalance. Visit Brain2Spine Institute to get your spine examined and find relief. Call to schedule your appointment (727) 351-6902.

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