Radiological analysis of ankylosing spondylitis patients with severe kyphosis before and after pedicle subtraction osteotomy
Radiological analysis of ankylosing spondylitis patients with severe kyphosis before and after pedicle subtraction osteotomy
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DOI：
10.1007/s00586-009-1158-7
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发表时间：
2010-01-01
影响因子：
2.8
通讯作者：
Roussouly, Pierre
中科院分区：
文献类型：
--
作者：
Debarge, Romain;Demey, Guillaume;Roussouly, Pierre
这是一项对强直性脊柱炎患者进行椎弓根截骨术的影像学研究。我们的目标是测量和验证新的角度，以评估整体脊柱后凸畸形，并评估术后影像学结果。这是第一份报告，描述了新的角度来评估整体脊柱后凸（T1-S1）。根据骨盆发病率比较术前和术后对照。对强直性脊柱炎患者和154例无症状患者的矢状面参数进行了比较。除了骨盆参数和C7倾斜度外，我们还使用了脊骶角。强直性脊柱炎患者的骨盆发生率高于无症状人群（61对51 A度）。对于两组C7倾斜度相同的情况，低骨盆发生率组的骶骨倾斜度和骨盆倾斜度较低，整体后凸（脊骶角= 90 A度）高于高骨盆发生率组（脊骶角= 98 A度）。在成年志愿者中，C7倾斜和脊柱骶骨角分别为95和135 A度。术前C7倾斜测量值为73 A度，增加至83 A度（p = 0.0025）。术前脊柱-骶骨角测量值为96 A度，增加至113.3 A度（p = 0.003）。低骨盆倾角骨盆的骶骨倾斜度比高骨盆倾角骨盆的骶骨倾斜度低，可以支撑更大的后凸。经椎弓根截骨术后，所有参数均得到改善，但平均脊柱-骶骨角仍低于对照组。当C7倾斜有助于评估平衡的改善时，SSA可以更好地评估脊柱后凸本身的矫正。
This is a radiographic study of ankylosing spondylitis patients with severe fixed kyphotic deformity who underwent pedicle subtraction osteotomy. Our goal was to measure and validate new angle to assess global kyphosis and to evaluate the radiological outcomes after surgery. This is the first report which describes new angle to assess global kyphosis (T1-S1). Pre and postoperative controls were compared according to the Pelvic Incidence. The sagittal parameters ankylosing spondylitis patients were compared with 154 asymptomatic patients. In addition to the pelvic parameters and the C7 tilt, we used the spino-sacral angle. Pelvic incidence in ankylosing spondylitis patients was higher than asymptomatic population (61 vs. 51A degrees). For a same tilt of C7 for both groups, the low pelvic incidence group had a lower sacral slope and pelvic tilt and a higher global kyphosis (spino-sacral angle = 90A degrees) than the high pelvic incidence group (spino-sacral angle = 98A degrees). In the adult volunteers, the C7 tilt and spino-sacral angle measured, respectively, 95 and 135A degrees. The preoperative C7 tilt measured 73A degrees and increased to 83A degrees (p = 0.0025). The preoperative spino-sacral angle measured 96A degrees and increased to 113.3A degrees (p = 0.003). A low pelvic incidence pelvis has a lower sacral slope than in high pelvic incidence and can support a bigger kyphosis. All the parameters were improved by the pedicle subtraction osteotomy, but the average spino-sacral angle remained lower than the control group. When C7 tilt was useful to assess the improvement of the balance, SSA allowed a better evaluation of the correction of kyphosis itself.