强直性脊柱炎继发寰枢椎脱位的研究现状

Current researches on atlantoaxial dislocation secondary to ankylosing spondylitis

寰枢椎位置重要,解剖结构脆弱,先天畸形、创伤、肿瘤、炎症等因素都可破坏其稳定性,威胁延髓生命中枢的安全。强直性脊柱炎是一种以骶髂关节炎和进行性脊柱强直为主要表现的慢性炎症性风湿病,其自然病程往往从骶髂关节和腰椎开始,随后扩散到胸椎和颈椎,病程晚期可累及上颈椎区域,造成寰枢椎脱位。尽管该病的发病率不高,但是起病隐匿,进展迅速,可造成严重神经压迫而致人死亡。本文就目前该疾病的研究现状做一综述。

The atlantoaxial spine locating at a specific position, is a vulnerable anatomical structure. Many factors might impair atlantoaxial stability, even threaten medulla the life center, including congenital malformation, trauma, tumor, inflammation and other pathologies. Ankylosing spondylitis(AS) is a chronic inflammatory rheumatism characterized by sacroiliac arthritis and progressive spinal rigidity. The natural course of the disease often begins from the sacroiliac and lumbar vertebrae, and then spreads to the thoracic and cervical vertebrae. At late stage of the disease, the upper cervical spine is involved to bring about atlantoaxial dislocation. Although this scenario in AS is rare, it occurs insidiously and progresses rapidly, which might lead to severe nerve compression, even death. This article reviews the current researches on this issue.