• Ki-Tack Kim, Sang-Hun Lee, Dae-Seok Huh, Hyo-Jong Kim, Jung-Youn Kim, and Jung-Hee Lee.
• Department of Orthopaedic Surgery, Kyung Hee University College of Medicine, Seoul, Korea.
• Asian Spine J. 2015 Jun 1;9(3):352-60.

Study DesignA retrospective comparative study.PurposeTo provide an ideal correction angle of lumbar lordosis (LL) in degenerative flat back deformity.Overview Of LiteratureThe degree of correction in degenerative flat back in relation to pelvic incidence (PI) remains controversial.MethodsForty-nine patients with flat back deformity who underwent corrective surgery were enrolled. Posterior-anterior-posterior sequential operation was performed. Mean age and mean follow-up period was 65.6 years and 24.2 months, respectively. We divided the patients into two groups based on immediate postoperative radiographs-optimal correction (OC) group (PI-9°≤LLResultsPatients in OC group had significantly less correction loss and maintained normal sagittal alignment (sagittal vertical axis<5 cm), as compared to patients in UC group (p<0.05). LL of low PI group significantly maintained within 9° better than high PI group (p<0.05). Oswestry disability index (ODI) significantly decreased at last follow-up, as compared to preoperative state. However, there was no significant difference in last follow-up ODI between the groups.ConclusionsIn flat back deformity, correction of LL to within 9° of PI will result in better sagittal balance. Thus, we recommend sufficient LL to prevent correction loss, especially in patients with high PI.

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