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

– Abstract – Study Design: Six patients with the lumbar kyphosis who underwent the circumferential fusion by posterior-anterior-posteri-or 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 pos-terior-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-anteri-or-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 2.8。preoperatively to lor-dosis 31.2。postoperatively. At the last follow-up, the average loss of correction was 2.3。. The average angle of sacral inclination was corrected from 6.7。to 50.8。. The distance from supero-posterior corner of S1 to C7 plumb line was reduced from 11.0 cm t