脊柱后凸全脊椎截骨术后矫正度丢失原因分析

Cause analysis of loss of correction after spine osteotomy in kyphosis

目的 分析强直性脊柱炎后凸畸形全脊椎截骨矫正术后矫正度丢失原因 ,提出预防方法。方法 对 95例行全脊椎截骨矫正的强直性脊柱炎后凸畸形患者进行平均 5年 6个月的随访 ,将术前、术后及随诊的X线片对比 ,分析矫正度丢失与疾病阶段、手术矫正程度、内外固定方法等多因素的关系。结果 矫正度丢失 <5°者 34例 ,丢失 6°～ 10°者 19例 ,丢失 11°～ 15°者 2 4例 ,丢失 16°～ 2 0°者 16例 ,丢失 >2 1°者 2例 (平均 12 .2°)。结论 为防止矫正度丢失 ,手术应在强直性脊柱炎病情稳定后进行 ,尽量恢复身体轴线 ,加强内外固定的可靠性 ,注意围手术期的护理。

Objective To analyse the loss of correction after spine osteotomy in ankylosing spondylitis kyphosis and suggest a method to prevent it.Methods We had follow-up surveyed 95 ankylosing spondylitis patients after correction ostecpomy for 5 years and 6 months.We compared the preoperative with postoperative reontegenogram and analyzed the relationship between the loss of correction and the stage of the disease,corrective degree after operation,internal or external fixation,and other elements.Results We found that in 34 cases the losses of correction were less than 5°,and in 19 cases the losses of correction were 6°～10°,in 24 cases the losses of correction were 11°～15°and in 16 cases the losses of correction were 16°～20°.There were 2 cases whose losses of corrcetion were more than 21°.The average loss of correction was 12.2°.Conclusion In order to prevent the loss of correction,the orthomorphia should be performed after the development of ankylosing spondylosis becomes stable,and try to correct the body axial angle to a normal degree;make the internal or external fixation reliable and pay more attention to the perioperative nursing care.