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Degenerative Kyphosis

Degenerative Kyphosis is increasingly prevalent and predominantly affects the elderly, who may be frail because of qualitative and quantitative weakening of the bones or osteoporosis, which makes instrumentation and fusion difficult. DLKS can exacerbate disc degeneration, spinal stenosis, and facet arthropathy, increasing spinal rigidity and making treatment difficult. Risks of instrumentation failure, nonunion, and adjacent-segment failure are considerable. Severe deformities can increase surgical morbidity and mortality. Therefore, conservative measures must be attempted first. Goals of surgery are to resolve intractable low back pain or radicular pain that interferes with activities of daily living or to make it controllable with medications, to reduce the drug load, and to fuse the spine in an anatomic position as normal as possible.

In Degenerative Kyphosis, increased extremity radicular pain and claudication are due to neural compression; this is relieved with thorough neurologic decompression. Degenerative pain is caused by disc and facet instability and degeneration due to deformity and imbalance; this is relieved with deformity correction, fixation, and fusion. Myogenic pain is caused by lumbar muscular fatigue and is relieved by restoring sagittal and coronal balance and approximating the promontory to the center of gravity line.

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