[Surgical method in treatment of total kyphosis in ankylosing spondylitis]

In spite of extensive, conservative methods for treating spondylitis, more or less distinct kyphotic deformities are common. Pain usually plays a minor role as an indication for surgery either as local instability or as impairment of the large hip or knee joints. Much more common are the loss of social contact and the lack of visual contact with the surroundings, both of which the patients find unacceptable. The monosegmental, lumbar correction method as used at an early stage implicated a high rate of complications. The implant supported methods, and in particular those that allow the potential for dorsal transpediculated fixation, allowed, in the early 1980s, dorsal lordotic measures in the form of a multilocus method and, in the mid-1980s, a modified monosegmentary method as well. Both of these methods are widely accepted because of their good long-term results. The possible complications no longer include the disturbance of the spinal cord but are rather to be found in the poor general condition of the patient. The restoration of a largely normal equilibrium of the backbone relieves the musculature and is therefore a definitive pain therapy for muscle tension problems. Straightening the backbone also relieves the hip joints and therefore it is possible in many cases to delay the implantation of a hip prosthesis.