| Surgical Result of Corrective Osteotomy for Post-fusion Lumbar Flatback Deformity in Elderly Patients |
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Jin Seong Kim1 , Sung Min Kim2 |
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1Department of Neurosurgery, Kyung Hee University Graduate School, Seoul,
2Department of Neurosurgery, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea |
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| Abstract |
Objective
To review the radiographic and clinical results of patients with post-fusion lumbar flatback deformity treated with lumbar osteotomies.
Methods
Fourteen elderly patients underwent corrective osteotomies. All patients were divided into 2 groups, LL ≥ pelvic incidence (PI)+10°, LL from PI+9° to PI-9°. Two groups were compared for PI-LL mismatch, sagittal vertical axis (SVA), and pelvic tilt (PT). Clinical outcomes were reviewed.
Results
Mean age was 71.6 years, and follow-up was 27 months. The mean LL was 5.8±18.0° kyphosis before surgery, which increased to -60.7±6.5° lordosis after surgery and was well maintained at -60.3±10.1° at the final follow up. The PI-LL mismatch was 62.6±19.1° preoperatively, -3.1±9.1° after surgery, and was well maintained at -2.4±8.8° at the final follow up. Likewise, the SVA was 182.8±76.9 mm preoperatively, 7.9±30.2mm after surgery, and 23±29.6mm at the final follow up. The PI+10° group showed the great improvement in radiological and clinical outcome at postoperative 1 month and at the final follow up. The mean scores for the Oswestry Disability Index (ODI) and Scoliosis Research Society-22 (SRS-22r) patient questionnaire were improved at the final follow-up.
Conclusion
For restoration and maintenance of normal sagittal balance, postoperative lumbar lordosis should be greater than PI+9°. Patient satisfaction with surgery and overall clinical outcomes are excellent. |
| Key Words:
Post-fusion lumbar flatback deformity, PSO, multilevel SPOs with ALIFs, Clinical Outcomes |
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