St udy Design : Prospective study.
Objectives : Analyzing the clinical outcome of operative treatment in lumbar degenerative kyphosis (LDK) by means of anterio ai A posterior operation using Wedged cage (SynCage) and pedicle screws.
Summary of Literature Review : LDK is common in old farmers who have worked in a stooping posture for decades and is qi dte rigid form of kyphosis accompanied by adjacent instability, dystrophic changes of vertebral bodies and weakness of bac aiid hip extensors. For surgical treatment, restoration and maintenance of lumbar lordosis is mandatory for global balanc( P nterior release and restoration of disc space with the same morphologic cage seems to be a quite anatomic and harmoniou a )proach.
Materials and Methods : Ten LDK patients, who underwent anterior interbody fusion using Wedged cage (SynCageW) and pos t, -rior fusion with pedicle screws between 2000 to 2001, were followed up for more than 2 years. The operation was done in on o- two stages. We performed anterior release, gradual widening of the intervertebral space with wedge trials of increasing siz iiisertion of wedged cages filled with auto-, allo- or synthetic bone and posterior pedicle fixation and fusion. We measured th 1 imbar lordotic angle, sacral inclination, fusion segmental angle, thoracic kyphotic angle and vertical axis line in preoperativ, nmediate postoperative and follow-up standing X-ray.
Results : Mean fusion segments using Wedged cage were 2.8 segments for anterior interbody fusion and 3.4 segments for pos
2rior fusion. Mean sagittal correction angle was 40.3 with mean correction loss of 2.6. Whole lordosis was 6.9 kyphosis pre operatively, which was corrected to 33.4 lordosis postoperatively and 30.8 lordosis at last follow-up. Mean sacral inclinatio vas corrected from 182 preoperatively to 37.8 postoperatively and 30.7 at follow-up. Vertical axis line was corrected fror 1.4 cm preoperatively to 0.4 cm postoperatively and 1.3cm at follow-up. Thoracic lordosis was corrected spontaneously withou my surgical extension to the thoracic spine by mean 19.9 (02´ lordosis preoperatively to 19.7 kyphosis at follow-up). Loss c :ardinal signs occurred in 70-80 % of patients and satisfactory clinical results were shown in 90% of patients.
conclusions : Anterior and posterior fusion using Wedged cage (SynCage´9) and pedicle screws showed high efficiency in the cor -ection and maintenance of LDK. It is a good modality in the surgical treatment of lumbar degenerative kyphosis.
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