J Korean Soc Spine Surg.  2001 Dec;8(4):541-547.

Reconstruction of Lumbar Kyphosis with circumferential Fusion by Posterior-Anterior-Posterior Approach

• Lee SH
• Shim JI
• Kim TS
• Kim YB
• Ko DC

Abstract

STUDY DESIGN: Six patients with the lumbar kyphosis who underwent the circumferential fusion by posterior-anterior-posterior method were reviewed retrospectively from January 1998 to June 1999.
OBJECTIVES
To determine whether patients with lumbar kyphosis can be successfully treated by circumferential fusion by posterior-anterior-posterior method. SUMMARY OF LITERATURE REVIEW: In the lumbar kyphosis, many procedures have been reported to correct the deformity, including multiple osteotomy, transpedicular vertebral resection, posterior interbody fusion, etc. Circumferential fusion by posterior-anterior-posterior method is suggested in this report as a valuable technique for excellent deformity correction and maintenance. MATERIAL AND METHODS: The surgery consists of posterior structural release with decompression followed by anterior structural release with interbody fusion by use of bone graft and posterior fixation. Clinical and radiologic results of the lumbar lordosis, sacral inclination and C7 plumb-line were assessed. RESULT: The mean segments of anterior and posterior fusion were 2.8 and 3.5 respectively. All clinical symptoms of patients had been improved in more than good. The average angle of lumbar lordosis was corrected from kyphosis 2.8degree preoperatively to lordosis 31.2degree postoperatively. At the last follow-up, the average loss of correction was 2.3degree . The average angle of sacral inclination was corrected from 6.7degree to 50.8degree . The distance from supero-posterior corner of S1 to C7 plumb line was reduced from 11.0 cm to 2.75 cm.
CONCLUSION
The circumferential fusion by posterior-anterior-posterior method offer an effective surgical treatment, which produce excellent deformity correction, fusion rate, maintenance of the correction and good clinical outcome.

Keyword

Lumbar; Kyphosis; Anterior and posterior fusion

MeSH Terms

Animals
Congenital Abnormalities
Decompression
Follow-Up Studies
Humans
Kyphosis*
Lordosis
Osteotomy
Retrospective Studies
Transplants

Figure

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  Fig. 1. Radiograph shows the lumbar kyphosis (1˚) with spondylolisthesis L3 on L4 for the previous failed back surgery syndrome.

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  Fig. 2. Postoperatively, trunk was well balanced with lordosis (23˚).

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  Fig. 3. 2 years later, radiograph shows solid bony union and no loss of the correction.

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