| 摘要: |
| 目的 探讨腰椎椎弓根楔形截骨术治疗强直性脊柱炎后凸畸形的临床疗效。方法 2005年1月至2010年3月,第二军医大学长海医院骨科共收治32例强直性脊柱炎后凸畸形患者,均行一期后路经腰椎椎弓根楔形截骨矫形内固定术。其中27例患者行单节段椎弓根楔形截骨术,5例患者行双节段椎弓根截骨术。术前及术后随访时拍摄脊柱全长X线片,测量影像学参数,并填写中文版脊柱侧凸研究学会22项(SRS-22)量表进行患者的健康生存质量评价。结果 手术时间平均为 (260±42) min,术中出血平均 (1 360±282) mL,平均随访 (31±8) 个月（24~76个月),均未出现神经系统并发症及假关节。患者颌眉角、全脊柱后凸角、胸腰段后凸角、腰椎前凸角由术前 (65.9±11.6)°、(78.2±15.9)°、(38.9±10.3)°、(-14.6±17.3)°分别矫正至术后(11.7±4.7)°、(38.9±10.3)°、(1.3±7.8)°、(26.2±5.6)°；身高和矢状面失平衡距离由术前的(135.4±15.2) cm、(37.2±11.3) cm分别矫正至术后的(166.2±9.6) cm、(12.7±7.7) cm,差异均有统计学意义(P<0.01)。SRS-22评分由术前平均(1.8±0.4)改善至术后(4.0±0.6),疗效满意。结论 腰椎椎弓根楔形截骨术治疗强直性脊柱炎后凸畸形安全可靠,可获得满意的临床效果。 |
| 关键词: 强直性脊柱炎 脊柱后凸 腰椎 截骨术 |
| DOI：10.3724/SP.J.1008.2013.00214 |
| 投稿时间：2012-10-31修订日期：2013-01-11 |
| 基金项目: |
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| Transpedicular lumbar wedge resection osteotomy for correction of kyphosis in ankylosing spondylitis |
| FAN Jian-ping,WANG Chuan-feng,ZHU Xiao-dong,CHEN Jia-yu,LI Chao,CHEN Chao,LIANG Nan,BAI Yu-shu,LI Ming* |
(Department of Orthopedics, Changhai Hospital, Second Military Medical University, Shanghai 200433, China
*Corresponding author.) |
| Abstract: |
| Objective To explore the clinical efficacies of transpedicular lumbar wedge resection osteotomy for correction of kyphosis in ankylosing spondylitis. Methods From January 2005 to March 2010,32 patients with ankylosing spondylitis kyphotic deformity received one stage posterior transpedicular wedge osteotomy and internal fixation, with 27 receiving single-level ones and 5 receiving two-level ones. All patients underwent X-ray examination of the total spine to obtain radiographic parameters and were asked to accomplish simplified Chinese scoliosis research society-22 (SRS-22) questionnaire to assess quality of health before and after operation. Results The mean operation time was (260±42) min and the mean blood loss was (1 360±282) mL in the patients. The patients were followed up for a mean of (31±8) months (range: 24-76 months) and there were no neurological complications and pseudarthrosis. The chin-brow vertical angle (CBVA), global thoraco-lumber kyphosis angle (TLKA), thoracolumbar kyphosis angle (TKA) and lumber lordosis angle (LLA) were (65.9±11.6)°, (78.2±15.9)°, (38.9±10.3)°, and (-14.6±17.3)° before operation and (11.7±4.7)°,(38.9±10.3)°,(1.3±7.8)°, and (26.2±5.6)° after operation, respectively; and significant differences were found for each parameter (P<0.01).The body height and the sagittal imbalance distance were improved from (135.4±15.2) cm and (37.2±11.3) cm before operation to (166.2±9.6) cm and (12.7±7.7) cm after operation, respectively. The average SRS-22 score increased from (1.8±0.4) before operation to (4.0±0.6) after operation, showing a satisfactory outcome. Conclusion Transpedicular lumbar wedge resection osteotomy is a safe and effective method for treatment of the ankylosing spondylitis kyphosis． |
| Key words: ankylosing spondylitis kyphosis lumbar vertebrae osteotomy |
