强直性脊柱炎并发椎间假关节形成的病理病因和治疗

Pathogenesis and treatment of pseudoarthrosis with ankylosing spondylitis

目的:探讨强直性脊柱炎并发椎间假关节形成的病理病因及治疗方法。方法:对我院1995年～2002年治疗的23例并发假关节的强直性脊柱炎患者的临床资料、病理变化和治疗方法进行回顾性分析。结果:保守治疗13例,手术治疗10例。其中7例行前路椎间融合固定,3例行后路椎间融合固定。经随访观察,假关节全部获得骨性融合,症状缓解。结论:假关节形成是强直性脊柱炎不常见的并发症,与外伤和异常应力有直接关系。对保守治疗无效和出现神经症状的病例行前路或后路椎间植骨融合固定手术治疗效果满意。

Objective:To discuss the etiology and pathologenesis of pseudoarthrosis complicating with ankylosing spondylitis and introduce the appropriate treatment.Method:The clinical features,radiological manifestations,pathological evidences and treatment outcomes in 23 patients admitted between 1995 and 2002 with pseudoarthrosis complicating with ankylosing spondylitis were analyzed.Result:13 patients and 10 patients were treated by conservative and operative methods respectively.Anterior interbody fusion with instrumentation was performed in 7 patients and posterior interbody fusion with instrumentation was performed in 3 patients.Bony fusion was obtained in all patients treated by anterior or posterior fusion operation and the back pain relieved.Conclusion:Pseudoarthrosis in ankylosing spondylitis is an uncommon complication,the pathogenesis of which is related to trauma or abnormal stress.For the patients with the failure of conservative treatment and with neurological deficits,anterior or posterior interbody fusion with instrumentation can produce a good result.