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Osteotomy of the Spine for Correction of Fixed Flexion Deformity

AMA Arch Surg. 1958;76(4):603-610. doi:10.1001/archsurg.1958.01280220123026.
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Osteotomy of the spine for correction of fixed flexion deformity has proved to be a very satisfactory procedure.

The disease of ankylosing spondylitis (rheumatoid arthritis of the spine; Marie-Strümpell arthritis) presents different phases of treatment. In the early stage medical and irradiation therapy, plus the prevention of deformity, is indicated. The second phase, with flexion deformity, but in which there is not complete bony fusion of articular facets and longitudinal ligaments, may be corrected or controlled by hyperextension frames, casts, and braces. In the final stage of the disease, however, in which bony ankylosis exists with severe fixed flexion deformity of the spine, osteotomy is indicated. This offers for the patient dramatic improvement not only in appearance but in general well-being and affords an important psychological lift.

Smith-Petersen, Larson, and Aufranc,13 in 1945, first described osteotomy of the spine and reported results in six cases. Since that report, La


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