Restoration of Lumbar Lordosis in Flat Back Deformity: Optimal Degree of Correction.

Ki Tack Kim; Sang Hun Lee; Dae Seok Huh; Hyo Jong Kim; Jung Youn Kim; Jung Hee Lee

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Restoration of Lumbar Lordosis in Flat Back Deformity: Optimal Degree of Correction.

Author: Ki Tack KIM ¹ ; Sang Hun LEE ; Dae Seok HUH ; Hyo Jong KIM ; Jung Youn KIM ; Jung Hee LEE
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1. Department of Orthopaedic Surgery, Kyung Hee University College of Medicine, Seoul, Korea.
Publication Type:Comparative Study ; Original Article
Keywords: Flat back deformity; Lumbar lordosis; Pelvic incidence
MeSH: Animals; Congenital Abnormalities*; Follow-Up Studies; Humans; Incidence; Lordosis*; Retrospective Studies
From:Asian Spine Journal 2015;9(3):352-360
CountryRepublic of Korea
Language:English
Abstract: STUDY DESIGN: A retrospective comparative study. PURPOSE: To provide an ideal correction angle of lumbar lordosis (LL) in degenerative flat back deformity. OVERVIEW OF LITERATURE: The degree of correction in degenerative flat back in relation to pelvic incidence (PI) remains controversial. METHODS: Forty-nine patients with flat back deformity who underwent corrective surgery were enrolled. Posterior-anterior-posterior sequential operation was performed. Mean age and mean follow-up period was 65.6 years and 24.2 months, respectively. We divided the patients into two groups based on immediate postoperative radiographs-optimal correction (OC) group (PI-9degrees< or =LL or =55degrees). Radiological and clinical results were analyzed. RESULTS: Patients in OC group had significantly less correction loss and maintained normal sagittal alignment (sagittal vertical axis<5 cm), as compared to patients in UC group (p<0.05). LL of low PI group significantly maintained within 9degrees better than high PI group (p<0.05). Oswestry disability index (ODI) significantly decreased at last follow-up, as compared to preoperative state. However, there was no significant difference in last follow-up ODI between the groups. CONCLUSIONS: In flat back deformity, correction of LL to within 9degrees of PI will result in better sagittal balance. Thus, we recommend sufficient LL to prevent correction loss, especially in patients with high PI.