Three different methods in deformity correction of degenerative flat back: A single surgeon's experience with 64 consecutive cases

Ki Tack Kim, Sang Hun Lee, Jung Hee Lee, Kyung Jung Kang, Jung Suk Lee, Eun Seok Son

Research output: Contribution to journalArticle

Abstract

Study Design: Retrospective study. Purpose: To evaluate the radiological and clinical results of three different methods in the deformity correction of a degenerative flat back. Overview of Literature: There are no comparative studies about different procedures in the treatment of degenerative flat back. Methods: Sixty-four patients who consecutively underwent corrective surgery for degenerative flat back were reviewed. The operations were performed by three different methods: posterior-only (group P, n=20), one-stage anterior-posterior (group AP, n=12), and two-stage anterior-posterior with iliac screw fixation (group AP-I, n=32). Medical and surgical complications were examined and radiological and clinical results were compared. Results: The majority of medical and surgical complications were found in group AP (5/12) and group P (7/20). The sagittal vertical axes were within normal range immediately postoperatively in all groups, but only group AP-I showed normal sagittal alignment at the final follow-up. Postoperative lumbar lordosis was also significantly higher in group AP-I than in group P or group AP and the finding did not change through the last follow-up. The Oswestry disability index was significantly lower in groups AP and AP-I than in group P at the final follow-up. Meanwhile, the operating time was the longest in group AP-I, and total amount of blood loss was larger in group AP-I and group AP than in group P. Conclusions: Anterior-posterior correction showed better clinical results than posterior-only correction. Two-staged anteriorposterior correction with iliac screw fixation showed better radiological results than posterior-only or one-staged anterior-posterior correction. Two-staged anterior-posterior correction with iliac screw fixation also showed a lower complication rate than one-staged anterior-posterior correction.

Original languageEnglish (US)
Pages (from-to)361-369
Number of pages9
JournalAsian Spine Journal
Volume9
Issue number3
DOIs
StatePublished - Jan 1 2015

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Keywords

  • Kyphosis
  • Lumbar vertebrae
  • Surgical procedures
  • Treatment outcome

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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