A modified posterior wedge osteotomy with interbody fusion for the treatment of thoracolumbar kyphosis with Andersson lesions in ankylosing spondylitis:a 5-year follow-up study  

作　　者：Hong-Yu Wei Chun-Ke Dong Yu-Ting Zhu Jun Zhou Ping Yi Feng Yang Ming-Sheng Tan 

机构地区：[1]Department of Orthopaedic Surgery,China-Japan Friendship Hospital,Beijing 100029,China [2]Graduate School,Beijing University of Chinese Medicine,Beijing 100029,China [3]Department of Education,China-Japan Friendship Hospital,Beijing 100029,China

出　　处：《Chinese Medical Journal》2020年第2期165-173,共9页中华医学杂志（英文版）

摘　　要：Background:Andersson lesions(ALs),also known as spondylodiscities,destructive vertebral lesions and spinal pseudarthrosis,usually occur in patients with ankylosing spondylitis(AS).Inflammatory and traumatic causes have been proposed to define this lesion.Different surgical approaches including anterior,posterior,and combined anterior and posterior procedure have been used to address the complications,consisting of mechanical pain,kyphotic deformity,and neurologic deficits.However,the preferred surgical procedure remains controversial.The aim of this study was to illustrate the safety,efficacy,and feasibility of a modified posterior wedge osteotomy for the ALs with kyphotic deformity in AS.Methods:From June 2008 to January 2013,23 patients(18 males,5 females)at an average age of 44.8 years(range 25–69 years)were surgically treated for thoracolumbar kyphosis with ALs in AS via a modified posterior wedge osteotomy in our department.All sagittal balance parameters were assessed by standing lateral radiography of the whole spine before surgery and during the followup period.Assessment of radiologic fusion at follow-up was based on the Bridwell interbody fusion grading system.Ankylosing spondylitis quality of life(ASQoL)and visual analog scale(VAS)scores were performed to evaluate improvements in daily life function and back pain pre-operatively and post-operatively.Paired t tests were used to compare clinical data change in parametric values before and after surgery and the Mann-Whitney U test was employed for non-parametric comparisons.The radiographic data change was evaluated by repeated measure analysis of variance.Results:The mean operative duration was 205.4 min(range 115–375 min),with an average blood loss of 488.5 mL(range 215–880 mL).Radiographical and clinical outcomes were assessed after a mean of 61.4 months of follow-up.The VAS back pain and ASQoL scores improved significantly in all patients(7.52±1.31 vs.1.70±0.70,t=18.30,P<0.001;13.87±1.89 vs.7.22±1.24,t=18.53,P<0.001,respectively).The thoraco

关 键 词：ANKYLOSING SPONDYLITIS Andersson LESIONS KYPHOSIS MODIFIED POSTERIOR wedge osteotomy 

分 类 号：R68[医药卫生—骨科学]