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Camptocormia or bent spine syndrome is clinically defined as a marked (>45°) thoracolumbar spinal flexion that occurs when a patient stands or walks but completely abates in the supine position.1 The underlying cause remains elusive in many patients, but it has been associated with various muscle diseases and movement disorders. Jankovic's series of 16 patients with camptocormia presenting to a movement disorder clinic comprised 11 patients with Parkinson's disease, 2 with primary axial dystonia, 2 with secondary dystonia (disc surgery, syringomyelia) and 1 with Tourette syndrome.1 Laroche et al reviewed 63 patients presenting to a rheumatology clinic with camptocormia.2 Only 23 of them received a neurological diagnosis (including Parkinson's disease, limb girdle muscular dystrophy and myotonic dystrophy), whereas 40 received a final label of delayed-onset paraspinal myopathy, a diagnosis of exclusion.
The patient presented to our clinic at the age of 70 years. She had a 11-year history of back pain, not helped by a lumbar laminectomy, but for 1 year she had become increasingly bent the further she walked. Her elder sister, who had Parkinson's disease, also had a flexed posture when …