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Naohisa Miyakoshi, Yoichi Shimada, Kyoji Okada, Michio Hongo, Yuji Kasukawa and Eiji Itoi

kyphosis. Case Report Presentation This 66-year-old female farmer presented with a 2-month history of progressive bilateral lower-limb weakness and numbness in the absence of trauma or other known causal factors. The patient exhibited incomplete paraplegia and was unable to stand without a walker when she visited our clinic. Examination Plain radiography demonstrated significant lumbar degenerative kyphosis and compensatory thoracic lordosis. With the patient standing, the apex of thoracic lordosis was at the T9–10 level. Thoracic MR imaging revealed

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Ho Yeong Kang, Sang-Ho Lee, Sang Hyeop Jeon and Song-Woo Shin

patients with infections. Three patients underwent surgery for correction of deformities. One patient had local lumbar kyphosis following a traumatic fracture and underwent an anterior corpectomy with adjacent artificial disc replacement and the use of mesh graft material; the next day facet screw augmentation was performed to stabilize the mesh graft. Another patient had lumbar degenerative kyphosis and underwent a one-level ALIF with TFS fixation combined with an adjacent two-level total disc replacement, and the third patient underwent two-level ALIF with TFS

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Jee-Soo Jang, Sang-Ho Lee, Jun-Hong Min and Dae Hyeon Maeng

curve shape decreases kyphosis or lordosis to compensate for the sagittal imbalance resulting from the loss of lumbar lordosis. Therefore, when a degenerative flat or kyphotic lumbar spine develops, the spine will form a new equilibrium, resulting in decreased thoracic kyphosis or in thoracic lordosis and pelvic retroversion. Degenerative flat back syndrome (or lumbar degenerative kyphosis) is one of the most common spinal deformities in Asia, although it is not commonly reported in Western countries. Takemitsu et al. 26 first described this pathological entity and

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Byung-Uk Kang, Won-Chul Choi, Sang-Ho Lee, Sang Hyeop Jeon, Jong Dae Park, Dae Hyeon Maeng and Young-Geun Choi

, increasing LOS by >7 days &/or has long-term (>6-mo) sequelae IV death TABLE 2: Summary of preoperative demographic data Parameter No. of Patients sex  male 114  female 298 previous lumbosacral op 43 previous abdominal op 22 diagnosis isthmic spondylolisthesis 132 degenerative spondylolisthesis 97 instability/stenosis 61 degenerative disc disease 60 failed back surgery syndrome 29 lumbar degenerative kyphosis 21 degenerative scoliosis 8 lumbar fracture 2

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Xinyu Liu, Yanguo Wang, Xiaojuan Wu, Yanping Zheng, Long Jia, Junyan Li, Kai Zhang, Jianmin Li and Bin Wei

O , Jolivet E , Dousset V , Degrise C , Obeid I , Vital JM , : Erector spinae muscle changes on magnetic resonance imaging following lumbar surgery through a posterior approach . Spine 32 : 1236 – 1241 , 2007 5 Hara M , Takayasu M , Takagi T , Yoshida J : En bloc laminoplasty performed with threadwire saw . Neurosurgery 48 : 235 – 239 , 2001 6 Kang CH , Shin MJ , Kim SM , Lee SH , Lee CS : MRI of paraspinal muscles in lumbar degenerative kyphosis patients and control patients with chronic low back pain

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Yasuchika Aoki, Masatsune Yamagata, Fumitake Nakajima, Yoshikazu Ikeda, Koh Shimizu, Masakazu Yoshihara, Junichi Iwasaki, Tomoaki Toyone, Koichi Nakagawa, Arata Nakajima, Kazuhisa Takahashi and Seiji Ohtori

herniation (8), degenerative scoliosis (6), lumbar spinal canal stenosis (4), ischemic spondylolisthesis (4), discogenic low-back pain (4), and lumbar degenerative kyphosis (1). Fusion was performed at 1 level in 109 patients, at 2 levels in 13 patients, and 3-level fusions were performed in 3 patients. There were 4 cases of posterior migration of fusion cages (2.8%). All 4 patients with postoperative cage migration had received 1-level TLIF for degenerative spondylolisthesis ( Fig. 3 ). One of the patients also had undergone posterolateral fusion at a level adjacent to

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Chi Heon Kim, Chun Kee Chung, Hee Suk Hong, Eun Hyun Kim, Min Jung Kim and Byung Joo Park

correlation coefficients . Statistician 51 : 367 – 379 , 2002 9 Gottfried ON , Daubs MD , Patel AA , Dailey AT , Brodke DS : Spinopelvic parameters in postfusion flatback deformity patients . Spine J 9 : 639 – 647 , 2009 10 Jang JS , Lee SH , Kim JM , Min JH , Han KM , Maeng DH : Can patients with sagittally well-compensated lumbar degenerative kyphosis benefit from surgical treatment for intractable back pain? . Neurosurgery 64 : 115 – 121 , 2009 11 Jang JS , Lee SH , Min JH , Han KM : Lumbar degenerative

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Carolyn J. Sparrey, Jeannie F. Bailey, Michael Safaee, Aaron J. Clark, Virginie Lafage, Frank Schwab, Justin S. Smith and Christopher P. Ames

is less stable and it is energetically more costly to maintain upright posture. Postural correction and balance within the spine appears to be an unconscious response moderated by neurocontrols. In patients with postural deformities, the strategies to compensate for a loss of sagittal balance are consistent across individuals. Those with moderate lumbar flattening compensate by further extending their thoracic spine and hyperextending their hips. 77 Patients with lumbar degenerative kyphosis who employed these compensatory strategies preoperatively showed an

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Taemin Oh, Justin K. Scheer, Robert Eastlack, Justin S. Smith, Virginie Lafage, Themistocles S. Protopsaltis, Eric Klineberg, Peter G. Passias, Vedat Deviren, Richard Hostin, Munish Gupta, Shay Bess, Frank Schwab, Christopher I. Shaffrey and Christopher P. Ames

position in lumbar degenerative kyphosis patients . Spine (Phila Pa 1976) 34 : 280 – 284 , 2009 8 Klineberg E , Schwab F , Ames C , Hostin R , Bess S , Smith JS , : Acute reciprocal changes distant from the site of spinal osteotomies affect global postoperative alignment . Adv Orthop 2011 : 415946 , 2011 9 Lafage V , Ames C , Schwab F , Klineberg E , Akbarnia B , Smith J , : Changes in thoracic kyphosis negatively impact sagittal alignment after lumbar pedicle subtraction osteotomy: a comprehensive radiographic analysis

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Sho Dohzono, Hiromitsu Toyoda, Tomiya Matsumoto, Akinobu Suzuki, Hidetomi Terai and Hiroaki Nakamura

-term results of microendoscopic posterior decompression for lumbar spinal stenosis. Technical note . J Neurosurg Spine 2 : 624 – 633 , 2005 8 Jackson RP , McManus AC : Radiographic analysis of sagittal plane alignment and balance in standing volunteers and patients with low back pain matched for age, sex, and size. A prospective controlled clinical study . Spine (Phila Pa 1976) 19 : 1611 – 1618 , 1994 9 Jang JS , Lee SH , Kim JM , Min JH , Han KM , Maeng DH : Can patients with sagittally well-compensated lumbar degenerative kyphosis