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Flatback Case Reviews |
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| The surgical procedure is individualized for each patient. Here is an example of a flatback patient that Dr. Pashman has treated. | |||||||||
 CT through L3 shows 90 degree rotation of spine and cross section thinness of fusion mass. |
A 31-year-old woman contracted polio as a child and developed a severe neuromuscular scoliosis. At 13 she was operated on in England, developed a pseudarthrosis and underwent reoperation. The last surgery left her with severe pelvic obliquity and multiple pseudarthrosis. She reported difficulty sitting and pain. On xrays, the patient had a severe triplane deformity with frontal and sagittal plane imbalance, pelvic obliquity, and rotational deformity. She had multiple pseudarthrosis and her management was complicated by osteoporosis.
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 The
following sequence of pictures illustrates her treatment. For correction,
the deformity required a triplane osteotomy and resection below the conus.
A pseudarthrosis between L2 and L3 was utilized as the upper boundary of
the resection. A low lumbar pseudarthrosis created multiple fragments in
the fusion mass, which were compressed with intermediate hook fixation.
Galveston-screw modification was utilized for pelvic fixation and the instrumentation
was carried up to T5. The vertebral resection and correction was complicated
by the fact that in the lumbar spine, the vertebra was rotated 90 degrees
so that what was once in the coronal, was now in the sagittal plane. She
was discharged from the acute care hospital without complication in 6 days
postop. |
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| Last modified: November 13th, 2005 | |||||||||
