Adult Degenerative Scoliosis with Flat Back Deformity

A 63-year-old gentleman presented with years of back pain. He also complained that his ribs were pressing and hurting against his pelvic bones — a hallmark sign of severe flat back deformity.

He was diagnosed with Lumbar Degenerative Scoliosis with Flat Back Deformity and Osteoporosis. While standing, he would stoop far forward and his head would be several centimetres ahead of his hips — an unsustainable posture that caused constant pain and functional limitation.

He was operated in two stages: 1. Anterior Lumbar Interbody Fusion (ALIF) from L2 to S1 through an incision on the belly 2. Posterior Percutaneous Pedicle Screw Placement from L2 to S1

This approach achieved excellent correction of his lumbar scoliosis, restoration of lumbar lordosis, and correction of sagittal spine alignment.

ALIF surgery restores natural lumbar lordosis and spinal alignment. It involves negligible blood loss and none of the paraspinal muscles are damaged. Percutaneous pedicle screw placement similarly preserves paraspinal muscles, leading to better outcomes compared to traditional open posterior lumbar fusion.