Three Different Methods in Deformity Correction of Degenerative Flat Back: A Single Surgeon's Experience with 64 Consecutive Cases

• Published in: Asian spine journal Vol. 9; no. 3; pp. 361 - 369
• Main Authors: Kim, Ki-Tack, Lee, Sang-Hun, Lee, Jung-Hee, Kang, Kyung-Jung, Lee, Jung-Suk, Son, Eun-Seok
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Spine Surgery 01.06.2015; Korean Spine Society; 대한척추외과학회
• Subjects: Clinical Study; Kyphosis; Lumbar vertebrae; Surgical procedures; Treatment outcome; 정형외과학; Treatment outcome; Kyphosis; Surgical procedures; Lumbar vertebrae
• ISSN: 1976-1902; 1976-7846
• DOI: 10.4184/asj.2015.9.3.361

Retrospective study. To evaluate the radiological and clinical results of three different methods in the deformity correction of a degenerative flat back. There are no comparative studies about different procedures in the treatment of degenerative flat back. 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. 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. Anterior-posterior correction showed better clinical results than posterior-only correction. Two-staged anterior-posterior 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.