title: Three Different Methods in Deformity Correction of Degenerative Flat Back: A Single Surgeon's Experience with 64 Consecutive Cases.
abstract: METHODS
  Retrospective study.
  
  
  OBJECTIVE
  To evaluate the radiological and clinical results of three different methods in the deformity correction of a degenerative flat back.
  
  
  BACKGROUND
  There are no comparative studies about different procedures in the treatment of degenerative flat back.
  
  
  METHODS
  Sixty-four patients who consecutively underwent corrective surgery for degenerative flat back were reviewed. The operations were performed by three different methods: posterior-only (group P, n=20), one-stage anterior-posterior (group AP, n=12), and two-stage anterior-posterior with iliac screw fixation (group AP-I, n=32). Medical and surgical complications were examined and radiological and clinical results were compared.
  
  
  RESULTS
  The majority of medical and surgical complications were found in group AP (5/12) and group P (7/20). The sagittal vertical axes were within normal range immediately postoperatively in all groups, but only group AP-I showed normal sagittal alignment at the final follow-up. Postoperative lumbar lordosis was also significantly higher in group AP-I than in group P or group AP and the finding did not change through the last follow-up. The Oswestry disability index was significantly lower in groups AP and AP-I than in group P at the final follow-up. Meanwhile, the operating time was the longest in group AP-I, and total amount of blood loss was larger in group AP-I and group AP than in group P.
  
  
  CONCLUSIONS
  Anterior-posterior correction showed better clinical results than posterior-only correction. Two-staged anterior-posterior correction with iliac screw fixation showed better radiological results than posterior-only or one-staged anterior-posterior correction. Two-staged anterior-posterior correction with iliac screw fixation also showed a lower complication rate than one-staged anterior-posterior correction.
authors.affiliation: Department of Orthopedic Surgery, Kyung Hee University College of Medicine, Seoul, Korea.
authors.forename: Ki-Tack
authors.initials: KT
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Kyung Hee University College of Medicine, Seoul, Korea.
authors.forename: Sang-Hun
authors.initials: SH
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Kyung Hee University College of Medicine, Seoul, Korea.
authors.forename: Jung-Hee
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Kyung Hee University College of Medicine, Seoul, Korea.
authors.forename: Kyung-Jung
authors.initials: KJ
authors.lastname: Kang
authors.affiliation: Department of Orthopedic Surgery, Kyung Hee University College of Medicine, Seoul, Korea.
authors.forename: Jung-Suk
authors.initials: JS
authors.lastname: Lee
authors.affiliation: Department of Orthopedic Surgery, Keimyung University School of Medicine, Daegu, Korea.
authors.forename: Eun-Seok
authors.initials: ES
authors.lastname: Son
keywords: Kyphosis; Lumbar vertebrae; Surgical procedures; Treatment outcome