Posterior correction and fixation without anterior fusion for pseudoarthrosis with kyphotic deformity in ankylosing spondylitis
Posterior correction and fixation without anterior fusion for pseudoarthrosis with kyphotic deformity in ankylosing spondylitis
复制标题
DOI：
10.1097/01.brs.0000219870.31561.c2
复制
发表时间：
2006-06-01
期刊：
影响因子：
3
通讯作者：
Lin, Chien-Chung
中科院分区：
文献类型：
--
作者：
Chang, Kao-Wha;Tu, Min-Yu;Lin, Chien-Chung
研究设计。回顾性审查。目的。评估后路矫正和不前路融合固定治疗强直性脊柱炎患者后凸假关节的有效性。背景数据摘要。前路融合术是目前治疗强直性脊柱炎假关节伴后凸畸形的手术方法。强直性脊柱炎的独特特征是在截骨部位充分固定后，具有桥接和融合后路截骨术产生的大的前部开口楔形间隙的能力，可矫正后凸，无需前路融合。即使存在假关节，这种能力也可能持续存在。方法。连续30例强直性脊柱炎患者（平均年龄41.7岁，范围29-55岁）接受后路矫正固定，不进行前路融合，治疗后凸的假关节。平均随访时间为 4.7 年（范围 2.2-9.1）。评估放射学和临床结果以及并发症。结果。局部后凸畸形从 45.5（范围 37-68）大幅矫正至 7.5（0-14），平均矫正度为 38。最终随访时，所有患者在假关节水平的 X 射线检查中均未发现骨不连的证据。没有人出现明显的矫正损失。未发生重大并发症。 3例神经功能缺损患者术后得到改善。结论。后路矫正固定对于治疗强直性脊柱炎后凸假关节是有效的。无需进行前路融合手术。
Study Design. Retrospective review.Objective. To assess the effectiveness of posterior correction and fixation without anterior fusion for pseudarthrosis with kyphosis in patients with ankylosing spondylitis.Summary of Background Data. Anterior fusion is the current surgical treatment for pseudarthrosis with kyphosis in ankylosing spondylitis. The unique characteristic in ankylosing spondylitis is the superior ability to bridge and fuse the large anterior opening-wedge gap created by posterior osteotomy to correct the kyphosis without anterior fusion after the osteotomy site is adequately fixed. This ability may persist even if pseudarthrosis is present.Methods. A total of 30 consecutive patients with ankylosing spondylitis (mean age 41.7 years, range 29-55) underwent posterior correction and fixation without anterior fusion to treat pseudarthrosis with kyphosis. Mean follow-up was 4.7 years (range 2.2-9.1). Radiographic and clinical results and complications were assessed.Results. Local kyphosis was substantially corrected from 45.5 (range 37-68) to 7.5 (0-14), with a mean correction of 38. All patients had no evidence of nonunion on x-ray at the level of the pseudarthrosis at final follow-up. None had a notable loss of correction. No major complication occurred. There were 3 patients with neurologic deficits who had postoperative improvement.Conclusion. Posterior correction and fixation is effective for treating pseudarthrosis with kyphosis in ankylosing spondylitis. No anterior fusion procedure was necessary.