What happens when the treatment a patient needs doesn’t fit neatly within the limitations of conventional medicine?

This case of Flat Neck Syndrome highlights an important conversation we need to be having in spine surgery.

Medicine cannot always be one-size-fits-all. Some of the most complex patients require us to think beyond traditional treatment pathways and consider carefully selected, evidence-informed off-label approaches when clinically appropriate.

“Off-label” does not mean experimental or unsafe. It means a treatment or device is being used outside of its specific FDA-approved labeling based on a physician’s clinical judgment, the individual patient’s pathology and an informed discussion of risks, benefits and alternatives.

This is central to what I call Restorative Motion Surgery—looking beyond simply decompressing or stabilizing the spine and asking whether we can restore alignment, preserve motion and reconstruct more natural biomechanics.

For the right patient, that distinction can be life-changing.

In this case study, I explain the pathology, the limitations of conventional treatment options and why an individualized motion-preserving approach was considered.

We should never treat an X-ray or an insurance policy. We treat the individual patient in front of us.

— Todd H. Lanman, MD