Three Different Methods in Deformity Correction of Degenerative Flat Back: A Single Surgeon's Experience with 64...

Area of Science:

• Spine surgery
• Orthopedic surgery
• Degenerative spinal disorders

Background:

• Degenerative flat back syndrome lacks comparative studies on surgical interventions.
• Evaluating different surgical techniques is crucial for optimizing treatment outcomes.

Purpose of the Study:

• To compare the radiological and clinical results of three surgical methods for degenerative flat back correction.
• Assess complications, sagittal alignment, lumbar lordosis, and functional outcomes.

Main Methods:

• Retrospective review of 64 patients undergoing corrective surgery for degenerative flat back.
• Comparison of three surgical groups: posterior-only (P), one-stage anterior-posterior (AP), and two-stage anterior-posterior with iliac screw fixation (AP-I).
• Analysis of medical/surgical complications, sagittal vertical axis, lumbar lordosis, and Oswestry disability index.

Main Results:

• The two-stage anterior-posterior with iliac screw fixation (AP-I) group demonstrated sustained normal sagittal alignment and higher lumbar lordosis.
• The AP and AP-I groups showed significantly lower Oswestry disability index scores compared to the posterior-only (P) group.
• The AP group had the highest complication rate, while the AP-I group had a lower rate than the AP group.

Conclusions:

• Anterior-posterior correction techniques yield better clinical results than posterior-only approaches for degenerative flat back.
• Two-stage anterior-posterior correction with iliac screw fixation provides superior radiological outcomes and reduced complications.
• Surgical method selection impacts radiological results, clinical outcomes, and complication rates in degenerative flat back treatment.