椎弓根螺钉内固定强直性脊柱炎后凸畸形:病例及文献分析

Effect of pedicle screw internal fixation on the treatment of ankylosing spondylitis kyphosis deformity: Analysis on the cases and literatures

背景:强直性脊柱炎后凸畸形患者,根据畸形的严重程度,采用单节段或两节段经椎弓根螺钉置入内固定矫形,可取得良好的矫形效果。目的:对经椎弓根螺钉内固定治疗强直性脊柱炎后凸畸形临床应用结果及研究文献进行多层次探讨分析。方法:对解放军306医院骨科椎弓根螺钉内固定治疗强直性脊柱炎后凸畸形的16例临床病例进行分析,并以电子检索的方式对CNKI数据库2002/2011椎弓根螺钉内固定治疗强直性脊柱炎后凸畸形研究文献进行检索,采用检索词为"螺钉;强直性脊柱炎;后凸",共检索相关文献48篇,进行数据特征等的深入分析。结果与结论:强直性脊柱炎是一种以侵犯中轴脊椎关节为特征的慢性疾病,晚期常合并胸段或胸腰段脊柱后凸畸形,经胸段脊椎屈曲增加,患者往往无法平视,严重的甚至肋骨下缘挤压内脏致心肺功能障碍,影响日常生活及美观,采用脊柱截骨,经椎弓根螺钉置入内固定矫形治疗,可取得良好的效果。

BACKGROUND： Patients with ankylosing spondylitis kyphosis deformity may be treated with single segment or two segment pedicle screw internal fixation according to the severity of deformity, and can obtain a good orthopedic effect. OBJECTIVE： To multi-level explore and analyze the clinical application results and literatures on the effect of pedicle screw internal fixation on the treatment of ankylosing spondylitis kyphosis deformity. METHODS： Sixteen clinical cases with ankylosing spondylitis kyphosis deformity treated with pedicle screw internal fixation were selected from the 306 Hospital of Chinese PLA for the analysis. A computer-based search was performed in CNKI database from 2002 to 2011 for the literatures on the effect of pedicle screw internal fixation on the treatment of ankylosing spondylitis kyphosis deformity. The were ＂pedicle screw, ankylosing spondylitis, kyphosis＂. A total of 48 literatures were screened out and the data characteristics were in-depth analyzed. RESULTS AND CONCLUSION： Ankylosing spondylitis is a kind of chronic diseases and has the characteristics of violation of the central axis of the spine joint, and in the advanced period, it often associates with thoracic or thoracolumbar ankylosing spondylitis kyphosis deformity. The patient is often unable to head-up after thoracic spine flexion increasing, and more serious, the lower ribs will squeeze internal organs and lead to cardiopulmonary dysfunct, which may affect the daily life and the aesthetics. Spinal osteotomy combined with pedicle screw internal fixation orthopedic treatment can achieve good results.