摘要
目的 总结应用弓型脊柱手术托架辅助单节段三柱截骨结合内固定系统治疗强直性脊柱炎后凸畸形的临床手术效果及治疗经验。方法 对 3 6例脊柱前柱严重骨化的强直性脊柱炎后凸畸形患者 ,应用弓型脊柱手术托架辅助术中调节体位 ,经后路进行L2 或L3 的三柱截骨 ,并辅以内固定。术后随访 4～ 3 4个月 ,平均 16个月。结果 后凸畸形矫正 15°～ 44° ,平均矫正 2 9.3°。患者重心前移、限制性肺通气不足、俯视等症状明显得到缓解 ,提高了生活质量 ,矫形效果患者满意率 94.4%。术后均未出现截瘫、大小便障碍 ;4例出现单侧、2例出现双侧下肢麻木症状 ,经药物治疗后缓解。结论 应用弓型脊柱手术托架辅助三柱截骨内固定手术治疗前柱严重骨化的强直性脊柱炎后凸畸形 ,疗效可靠满意 。
Objective To sum up the result and the clinical experience of 36 cases suffered kyphosis which were due to ankylosing spondylitis and were corrected by three-columniation-osteotomy and internal fixation assisted with the bow-type bracket for spinal operation.Methods 36 patients suffered kyphosis due to ankylosing spondylitis were selected, whose front spinal columniation were seriously ossified. Assisted with the bow-type bracket by adjusting the body′s position during the operation, carried through a three-columniation-osteotomy on each L 2 or L 3 vertebrae body. Inner fixation were performed later. Postoperative follow-up were 4～34 months and averaged 16 months.Results\ The correction in Cobb′s angles was 29.3° ranging from 15° to 44°. The patients were relieved of forward-moving barycenter, restrictive pulmonary ventilation deficiency and the overseeing of sight line. The quality of life were improved distinctly. The satisfactory rate of the patients was 94.4%. There were no paraplegia, impediment of emiction or defecation. Anesthesia of single lower limb occurred in 4 cases, and anesthesia of double lower limbs occurred in 2 cases, which were alleviated after medication.Conclusions\ Assisted with the bow-type bracket for spinal operation, surgery treatment of three-columniation-osteotomy and inner fixation on the correction of kyphosis due to ankylosing spondylitis would be safe, simple, satisfactory and reliable.
