强直性脊柱炎患者严重脊柱后凸畸形的手术治疗

The surgical treatment of ankylosing spondylitis patients with severe kyphosis.

目的探讨通过后路截骨矫形椎弓根钉固定治疗强直性脊柱炎患者陈旧性胸腰椎骨折引起的严重胸腰段脊柱后凸畸形的临床疗效。方法我院自2002-08-2012-12手术治疗的16例强直性脊柱炎合并严重胸腰段脊柱后凸畸形患者进行回顾性分析,分析内容包括术前、术后3个月及术后1年患者疼痛VAS评分,后凸Cobb角、术后并发症。结果 16例患者术前、术后3个月、术后1年VAS评分分别为(7.2±1.2)、(1.2±0.7)、(1.2±0.6)分,后凸Cobb角分别为(43.1°±6.8°)、(10.8°±4.2°)、(11.2°±3.8°),患者疼痛及后凸畸形较术前有明显改善。结论该手术方法治疗强直性脊柱炎患者陈旧性胸腰椎骨折引起的严重胸腰段脊柱后凸畸形,取得良好的疗效。

Objective To explore the efficacy of the posterior osteotomy pedicle screw fixation in the treatment of patients with ankylosing spondylitis old thoracolumbar fractures caused severe thoracolumbar kyphosis,and to provide a reference for surgical treatment. Methods From August 2002 to December 2012,the clinical data of 16 patients with ankylosing spondylitis and severe thoracolumbar kyphosis who received surgical treatment were retrospectively analyzed. The VAS score and kyphosis Cobb angle at preoperation,three months and one year postoperation,and postop-erative complications were analyzed. Results Before surgery, three months and 1 year after opera-tion,the VAS scores were（7.2±1.2）,（1.2±0.7）,（1.2±0.6）points,kyphosis Cobb angle were（43.1°±6.8°）, （10.8°±4.2°）,（11.2°±3.8°）. The patients＇ pain and kyphosis were significantly improved than before operation. Conclusion The surgical methods in the treatment of patients with ankylosing spondyli-tis old thoracolumbar fractures caused severe thoracolumbar kyphosis,can achieve good results,and significantly improve the patients＇ quality of life.