J Korean Med Assoc.  2021 Nov;64(11):748-752. 10.5124/jkma.2021.64.11.748.

Etiology, diagnosis, and treatment of iatrogenic spinal deformity

Affiliations
  • 1Department of Orthopedic Surgery, Ajou University School of Medicine, Suwon, Korea

Abstract

Background
Spinal fusion is a common procedure that provides spinal stability by connecting vertebral segments using a bone graft. Because the spinal alignment is fixed permanently after spinal fusion, a mal-aligned fusion can produce iatrogenic spinal deformity and imbalance with significant disability.
Current Concepts
Failure to restore adequate segmental lordosis in lumbar spinal fusion is a common cause of iatrogenic spine deformity. Local and regional spinal deformities can affect the global alignment; accordingly, spinal imbalance can occur when the compensation mechanisms fail. Diagnosis and surgical planning should be made on a thorough analysis of global and spinopelvic parameters on the standing whole-spine radiographs. Surgical treatment includes neural decompression, spinal fusion, and deformity correction. Spinal osteotomy provides a favorable surgical outcome, although the complication rate is high.
Discussion and Conclusion
Iatrogenic spine deformity is increasing due to the increased occurrence of spinal fusion surgery. To prevent iatrogenic spine deformity, the index fusion surgery should be performed based on a comprehensive analysis of spinopelvic alignment and balance.

Keyword

Iatrogenic disease; Spinal disease; Deformity; Spinal fusion; 의인성질환; 척추질환; 변형; 척추유합술
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