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Study Design.

Clinical case series.

Objective.

To describe a series of patients with progressive sagittal decompensation caused by failure at the caudal end of an instrumented lumbar fusion.

Summary of Background Data.

Lumbar kyphosis in association with global sagittal decompensation can be a disabling problem, particularly as a late complication of distraction instrumentation. Although kyphosis at the rostral end of instrumented fusions secondary to adjacent segment degeneration has been well described, substantially less has been documented about failure and kyphosis at the caudal end.

Methods.

Patients who have a progressive lumbar kyphosis and sagittal decompensation requiring operative revision were retrospectively reviewed, and radiographic measurements of lumbar lordosis and sagittal balance were performed to study this problem.

Results.

There were 13 patients identified. The most common …