后路椎间植骨融合内固定治疗强直性脊柱炎合并胸椎Andersson病损

Internal fixation of the posterior intervertebral bone graft fusion for ankylosing spondylitis complicated with thoracic Andersson lesion

目的 回顾性分析后路椎间植骨融合内固定治疗强直性脊柱炎（AS）合并胸椎Andersson 病损（AL）的疗效及可行性.方法 选择2008年1月至2014年6月15例采用后路椎间融合器植入植骨融合内固定术治疗的AS合并不同程度的胸椎AL患者,随访＆gt;2年.对15例患者临床表现和术前、术后的脊柱全长X线片、CT及MRI检查资料进行分析,测量后凸角度及矢状位平衡、Oswestry功能障碍指数（ODI）、术后CT椎体植骨融合程度.结果 所有患者手术顺利,术后效果满意.平均后凸角度由51.7°降至32.2°;平均矢状面平衡由术前的85.7 mm改善至随访时的45.1 mm;平均ODI由术前的54.9%改善至随访时的21.9%;术后随访后凸矫形效果良好,CT显示胸椎Andersson病损部位获得良好骨性融合.结论 后路椎间植骨融合内固定手术可获得良好融合,部分矫正后凸畸形,是治疗胸椎AL安全有效的方法.

Objective To retrospectively analyze the efficacy and feasibility of internal fixation of the posterior intervertebral bone graft fusion for ankylosing spondylitis（AS）complicated with thoracic Andersson lesion（AL）.Methods From January 2008 to June 2014, the data of 15 consecutive patients suffering AS complicated with different levels of thoracic Andersson lesion treated by internal fixation of the posterior intervertebral bone graft fusion were analyzed retrospectively.All the patients completed follow-up of at least 2 years.The clinical manifestations, preoperative and postoperative MRI, CT and X-ray examination of the spinal were collected for analysis;Kyphosis angle, sagittal vertical axis（SVA）, Oswestry disability index （ODI） and degree of postoperative CT vertebral bone graft fusion were measured.Results All patients were operated successfully, the postoperative results were satisfactory.The average kyphosis angle decreased from 51.7 ° to 32.2 °;The average sagittal balance improved from 85.7 mm preoperatively to 45.1 mm of follow-up, the mean ODI improved from 54.9% preoperatively to 21.9% of follow up.After follow-up, the effect of kyphosis correction was good.CT showed thoracic Adersson lesion obtain good bony fusion.Conclusions Internal fixation of the posterior intervertebral bone graft fusion surgery can get good fusion, partly correct protrusion deformity, it is a safe and effective treatment of ankylosing spondylitis （AS） of complicated with thoracic Andersson lesion.