脊柱去松质骨化截骨术治疗强直性脊柱炎并后凸畸形  

Analysis of curative effect of kyphosis cancellous ossification osteotomy for ankylosing spondylitis

作　　者：吕工一[1] 张晓林[1] 苗军[1] 

机构地区：[1]天津市天津医院脊柱外科,300211

出　　处：《中华实验外科杂志》2017年第2期335-337,共3页Chinese Journal of Experimental Surgery

摘　　要：目的探讨脊柱去松质骨化截骨术治疗强直性脊柱炎并脊柱后凸畸形的疗效。 方法选取天津医院脊柱外科收治的强直性脊柱炎合并后凸畸形患者34例，随机分为观察组和对照组，观察组采用脊柱去松质骨化截骨术联合椎弓根内固定治疗，对照组采用脊椎楔形截骨术联合椎弓根内固定治疗，测量并比较两种手术的手术时间、术中出血量和畸形纠正程度，并观察并发症发生。 结果观察组胸椎后凸角由术前（37.4±10.0）°分别在术后2周、3个月矫正到（1.8±0.5）°、（1.9±0.9）°，腰椎前凸角由术前（－13.7±17.3）°分别在术后2周、3个月矫正到（27.0±7.2）°、（27.3±6.8）°、矢状面平衡由术前（35.8±10.6）°分别在术后2周、3个月矫正到（12.7±4.2）°、（12.9±4.4）°、颌眉角由术前（63.5±11.1）°分别在术后2周、3个月矫正到（12.8±3.1）°、（12.6±3.6）°，与对照组比较差异无统计学意义（P＝0.077）。而术后6个月和末次随访时差异有统计学意义（P＝0.035）；观察组在末次随访时植骨融合率100.0%，高于对照组的83.4% （P＝0.007），脊柱功能评分观察组也高于对照组（P＝0.041）。 结论脊椎去松质骨化截骨术应用于强直性脊柱炎后凸畸形患者，可有效恢复脊柱高度，防止矫形过度或丢失，提高植骨融合率。Objective To investigate the efficacy to cancellous ossification of spinal osteotomy for the treatment of ankylosing spondylitis kyphosis deformity and. Methods 34 patients with ankylosing spondylitis kyphosis in our Department from Jan 2014 January to Fab 2016 were selected and randomly di- vided into the observation group and the control group, the observation group used to cancellous ossification of spinal osteotomy combined with pedicle screw internal fixation for the treatment, control group using spi- nal wedge osteotomy combined with pedicle screw internal fixation for the treatment of bleeding, and deform- ity correction the extent of operation time ,operation measure and comparison of two kinds of operation, and postoperative complications. Results In the observation group, the kyphotic angle of the thoracic vertebra was corrected from （37.4 ± 10. 0）° to （ 1.8 ± 0. 5 ）° and then to （ 1.9 ± 0. 9 ）°, laparoscopic angle was corrected from （ - 13. 7± 17. 3）° to （27. 0 ± 7. 2）° and then to （27. 3 ±6. 8 ）°, the sagittal plane bal- ance was calculated from preoperative （35.8 ± 10. 6） ° to （ 12.7 ±4. 2）° andthen to （ 12. 9 ±4. 4）°, the maxillary angle was corrected from （ 63.5 ± 11.1 ）° to （ 12. 8± 3.1 ）° and then to （ 12. 6 ± 3.6 ）° at the second week and the third month, respectively, there was no significant difference compared with the control group （P = 0. 077）. While the sixth month after the end of follow-up,the difference was statistically significant （P =0. 035） ;In the observation group,the fusion rate of bone graft was 100.0% higher than that of the control group （ 83.4% ） （ P = 0. 007 ）. The observation group of spine function also had a significant difference in the follow-up period Higher than the control group （ P = 0. 041 ）. Conclusion The spine to cancellous ossification osteotomy used in ankylosing spondylitis kyphosis has good curative effect, can effectively restore the spinal height, prevent orthopedi

关 键 词：去松质骨化 截骨 强直性脊柱炎 后凸畸形 

分 类 号：R687.31[医药卫生—骨科学]