成人强直性脊柱炎合并下颈椎骨折临床诊疗指南(2024版)  

Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults(version 2024)

作　　者：王庆德[1] 贺园 陈伯华[3] 初同伟 都金鹏 董健[6] 冯皓宇 范顺武[8] 冯世庆 高延征[10] 官众[11] 郭华 海涌[12] 贺利军 蒋电明 姜建元[14] 林斌 刘斌[16] 刘宝戈[17] 李淳德[18] 李放 李锋[20] 吕国华[21] 李利[22] 廖琦[23] 李危石[24] 刘晓光[24] 刘宏建[25] 刘勇[26] 刘忠军[24] 鲁世保[27] 邱勇[28] 戎利民[29] 申勇[30] 沈慧勇[31] 舒钧[32] 宋跃明[33] 孙天胜 王岩[22] 王哲 王征[22] 夏虹 殷国勇[36] 闫景龙[37] 袁文 叶招明[39] 赵杰[40] 仉建国[41] 朱悦[42] 周英杰 张忠民[44] 梅伟[1] 郝定均 贺宝荣[5] 中国医师协会骨科医师分会脊柱创伤学组[45] Wang Qingde;He Yuan;Chen Bohua;Chu Tongwei;Du Jinpeng;Dong Jian;Feng Haoyu;Fan Shunwu;Feng Shiqing;Gao Yanzheng;Guan Zhong;Guo Hua;Hai Yong;He Lijun;Jiang Dianming;Jiang Jianyuan;Lin Bin;Liu Bin;Liu Baoge;Li Chunde;Li Fang;Li Feng;Lyu Guohua;Li Li;Liao Qi;Li Weishi;Liu Xiaoguang;Liu Hongjian;Liu Yong;Liu Zhongjun;Lu Shibao;Qiu Yong;Rong Limin;Shen Yong;Shen Huiyong;Shu Jun;Song Yueming;Sun Tiansheng;Wang Yan;Wang Zhe;Wang Zheng;Xia Hong;Yin Guoyong;Yan Jinglong;Yuan Wen;Ye Zhaoming;Zhao Jie;Zhang Jianguo;Zhu Yue;Zhou Yingjie;Zhang Zhongmin;Mei Wei;Hao Dingjun;He Baorong;Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association(Zhengzhou Orthopedics Hospital,Zhengzhou 450052,China;Xi′an Fifth Hospital,Xi′an 710082,China;Affiliated Hospital of Qingdao University,Qingdao 266003,China;Second Affiliated Hospital of Army Medical University,Chongqing 400037,China;Honghui Hospital,Xi′an Jiaotong University,Xi′an 710054,China;Zhongshan Hospital Affiliated to Fudan University,Shanghai 200032,China;Shanxi Bethune Hospital,Taiyuan 030032,China;Sir Run Run Shaw Hospital,Zhejiang University Medical College,Hangzhou 310016,China;Second Hospital of Shandong University,Jinan 250033,China;Henan Provincial People′s Hospital,Zhengzhou 450003,China;Affiliated Hospital of Qinghai University,Xining 810001,China;Affiliated Beijing Chaoyang Hospital of Capital Medical University,Beijing 100020,China;Third Affiliated Hospital of Chongqing Medical University,Chongqing 401120,China;Huashan Hospital Affiliated to Fudan University,Shanghai 200040,China;th Hospital of Joint Logistics Support Force of PLA,Zhangzhou 363099,China;Inner Mongolia Medical University,Hohhot 101110,China;Affiliated Beijing Tiantan Hospital of Capital Medical University,Beijing 100070,China;Peking University First Hospital,Beijing 100034,China;Seventh Medical Center of Chinese PLA General Hospital,Beijing 100026,China;Tongji Hospital,Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430030,China;Second Xiangya

机构地区：[1]郑州市骨科医院,郑州450052 [2]西安市第五医院,西安710082 [3]青岛大学附属医院,青岛266003 [4]陆军军医大学第二附属医院,重庆400037 [5]西安交通大学附属红会医院,西安710054 [6]复旦大学附属中山医院,上海200032 [7]山西白求恩医院,太原030032 [8]浙江大学医学院邵逸夫医院,杭州310016 [9]山东大学第二医院,济南250033 [10]河南省人民医院,郑州450003 [11]青海大学附属医院,西宁810001 [12]首都医科大学附属北京朝阳医院,北京100020 [13]重庆医科大学附属第三医院,重庆401120 [14]复旦大学附属华山医院,上海200040 [15]解放军联勤保障部队第九○九医院,漳州363099 [16]内蒙古医科大学,呼和浩特寺101110 [17]首都医科大学附属北京天坛医院,北京100070 [18]北京大学第一医院,北京100034 [19]中国人民解放军总医院第七医学中心,北京100026 [20]华中科技大学同济医学院附属同济医院,武汉430030 [21]中南大学湘雅二医院,长沙410012 [22]中国人民解放军总医院,北京100853 [23]南昌大学附属第三医院,南昌330008 [24]北京大学第三医院,北京100191 [25]郑州大学第一附属医院,郑州450052 [26]西藏自治区人民医院,拉萨850010 [27]首都医科大学附属北京宣武医院,北京100053 [28]南京大学医学院附属鼓楼医院,南京210008 [29]中山大学附属第三医院,广州1510630 [30]河北医科大学第三医院,石家庄050051 [31]中山大学附属第八医院,深圳518033 [32]昆明医科大学第二附属医院,昆明650106 [33]四川大学华西医院,成都610041 [34]空军军医大学西京医院,西安710032 [35]解放军南部战区总医院,广州510010 [36]南京医科大学第一附属医院,南京210029 [37]哈尔滨医科大学附属第二医院,哈尔滨150001 [38]海军军医大学第二附属医院,上海200003 [39]浙江大学医学院附属第二医院,杭州310009 [40]上海交通大学医学院附属第九人民医院,上海每200011 [41]北京协和医院,�

出　　处：《中华创伤杂志》2024年第2期97-106,共10页Chinese Journal of Trauma

摘　　要：强直性脊柱炎(AS)合并下颈椎骨折多属不稳定骨折,具有神经损伤发生率高、致残致死率高等特点。由于肩部遮挡等因素影响X线影像学诊断的准确性,首诊时易漏诊。非手术治疗存在骨不连等并发症且有神经功能再损伤的可能。而在手术时机、入路及方式选择方面尚存争议。目前,AS合并下颈椎骨折伴或不伴脱位的诊疗方案尚无临床实践指南。因此,中国医师协会骨科医师分会脊柱创伤学组组织相关专家,遵循循证医学原则,本着科学性和实用性,制订《成人强直性脊柱炎合并下颈椎骨折临床诊疗指南(2024版)》,从诊断、影像学评估、分型及治疗等方面提出11条推荐建议,为AS合并下颈椎骨折的诊疗提供指导。Ankylosing spondylitis(AS)combined with lower cervical fracture is often categorized into unstable fracture,with a high incidence of neurological injury and a high rate of disability and morbidity.As factors such as shoulder occlusion may affect the accuracy of X-ray imaging diagnosis,it is often easily misdiagnosed at the primary diagnosis.Non-operative treatment has complications such as bone nonunion and the possibility of secondary neurological damage,while the timing,access and choice of surgical treatment are still controversial.Currently,there are no clinical practice guidelines for the treatment of AS combined with lower cervical fracture with or without dislocation.To this end,the Spinal Trauma Group of Orthopedics Branch of Chinese Medical Doctor Association organized experts to formulate Clinical guidelines for the treatment of ankylosing spondylitis combined with lower cervical fracture in adults(version 2024)in accordance with the principles of evidence-based medicine,scientificity and practicality,in which 11 recommendations were put forward in terms of the diagnosis,imaging evaluation,typing and treatment,etc,to provide guidance for the diagnosis and treatment of AS combined with lower cervical fracture.

关 键 词：脊柱炎 强直性 颈椎 脊柱骨折 指南 

分 类 号：R593.23[医药卫生—内科学] R683[医药卫生—临床医学]