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KMID : 1189320150090030361
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Asian Spine Journal
2015 Volume.9 No. 3 p.361 ~ p.369
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Three Different Methods in Deformity Correction of Degenerative Flat Back: A Single Surgeon's Experience with 64 Consecutive Cases
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Kim Ki-Tack
Lee Sang-Hun
Lee Jung-Hee
Kang Kyung-Jung
Lee Jung-Suk
Son Eun-Seok
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Abstract
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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 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.
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KEYWORD
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Lumbar vertebrae, Kyphosis, Surgical procedures, Treatment outcome
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