Comparative Analysis of Surgical Options in the Treatment of Lumbar Degenerative Kyphosis

Abstract

Study Design: A retrospective study Objectives: To compare the radiological and clinical outcomes of three surgical methods Summary of literature Review: There were many proposed surgical treatments for lumbar degenerative kyphosis but the best treatment is still controversial. Materials and Methods: Thirty three patients (all female) had undergone surgery. The mean age at surgery was 61.2. The average follow-up period was 34.7 months. The patients were divided into three groups. Group A included 7 cases with a correction by a posterior osteotomy, Group B included 15 with a posterior correction without an osteotomy, and Group C included 11 with combined anterior-posterior surgery. The radiographic measurements of lumbar lordosis, upper lumbar lordosis, lower lumbar lordosis, and pelvic tilt were performed before surgery, after surgery, and at the final follow-up visit. The loss of correction, complication rates and the clinical results were also compared. Results: Postoperative correction of the lumbar and lower lumbar lordosis were significantly higher in group A and C than group B. The correction of upper lumbar lordosis was significantly higher in group A than group C. On the final follow-up, there was no significant difference in the loss of correction and clinical results between the three groups. The number of cases with complications in groups A, B and C was 4 (57%), 2 (13.3%) and 2 (18.2%), respectively. Two patients in group A required additional surgery. Conclusions: Groups A and C were more effective than posterior-only correction. There was no significant difference in the clinical results between the three groups but complication rate was higher in Group A than the other groups. Combined anterior and posterior surgery can be a safe and effective method for correction.