摘要
目的:探讨单节段"蛋壳"椎体截骨技术治疗强直性脊柱炎脊柱后凸畸形的临床疗效。方法:2001年6月~2008年10月采用单节段"蛋壳"椎体截骨技术治疗34例强直性脊柱炎后凸畸形患者。术前、术后均行胸腰椎X线检查,测量胸椎后凸角、腰椎前凸角、骶骨水平角,评定植骨愈合情况、临床疗效、内固定位置及手术并发症。结果:术后X线示所有患者内固定位置良好,最终随访时植骨愈合满意。3例患者术中硬膜破裂,术后1例发生麻痹性肠梗阻,2例发生下肢疼痛、肌力减弱,均恢复。术前腰椎前凸角与术后相比,平均矫正角度为34.5°,有显著性差异(P<0.05),骶骨水平角的改变与此类似。胸椎后凸角术前、术后改变不明显。患者身高较术前平均增加5.2cm。术后患者腰背症状消失或大部分缓解,均能平视行走及水平仰卧睡眠。结论:单节段"蛋壳"椎体截骨技术治疗强直性脊柱炎后凸畸形,手术相对安全,矫形效果及临床疗效较理想。
Objective:To investigate the therapeutic effect of mono-segment "eggshell"technique of vertebra osteotomy for treatment of kyphosis deformity caused by ankylosing spondylitis.Methods:From June 2001 to October 2008,34 eases of kyphosis deformity ankylosing spondylitis patients were treated with mono-scgment "eggshell" technique of vertebra osteotomy.The thoracic-waist vertebra radiographs were taken pre-and postop- eratively to measure thoracic kyphosis angle,lumbar lordosis angle and saerohorizontal angle,in order to evaluate bone-graft healing condition,curative effect,internal fixation location and operational complications.Results: The postoperative radiographs showed that all the patients internal fixation were better located,the bone-graft healing were Satisfactory at final follow-up.Complications were rupture of dura mater in 3 cases and paralytic intestinal obstruction in 1 case.Two eases occurred legs ache and weaken myodynamia,but all had recovered. The average rectification angle of lumbar lordosis angle was 34.5° comparing the pre-and postoperative condition,the differences have statistical significance (P〈0.05)and the alteration of sacrohorizonta angles was similar. Whereas thoracic kyphosis angle remained no ehange(P〉0.05).The patients body height were increased by average 5.2 em.After operation,the patients waist and back symptoms were disappeared or partly relieved,all can walk with orthophoria and lie horizonally.Conclusion:The treatment of kyphosis deformity caused by ankylosing spondylitis with the method of mono-segment"eggsheU"technique of vertebra osteotomy showed that the rectification degree is high,and operation is relatively safe and can hopefully obtain the orthopedic effect and curative effect.
出处
《中日友好医院学报》
2010年第1期8-10,14,F0002,共5页
Journal of China-Japan Friendship Hospital
关键词
后凸畸形
截骨术
强直性脊柱炎
胸腰椎
kyphosis deformity
osteotomy
ankylosing spondylitis
thoracic-waist vertebra