单节段经椎弓根椎体截骨术治疗强直性脊柱炎

摘要

Objective To investigate the therapeutic effect of transpedicular wedge osteotomy for treatment of kyphosis deformity caused by ankylosing spondylitis. Methods From 2005 to 2010, 20 cases of kyphosis deformity ankylosing spondylitis patients were treated with transpedicular wedge osteotomy. The radiographs were taken pre-and postoperativ-ely to evaluate rectification of thoracic-waist Cobb angle, bone healing condition, curative effect, internal fixation location and operational complications. Result No death and infection occurred. Dural tear in 2, paralytic ileus in 1 .transient paresis in 2. All patients were followed up for 15 to 60 months, Kyphosis deformity was rectified with average rectification angle of thoracic-waist Cobb angle was 35.6°( P<0.05)The bone fusion was achieved, no fracture or looseness of internal fixation. Conclusion The treatment for kyphosis deformity of ankylosing spondylitis by transpedicular wedge osteotomy obtained satisfactory the orthopedic effect and curative effect.%目的 总结单节段经椎弓根椎体截骨术治疗强直性脊柱后凸畸形的临床疗效.方法 2005～2010采取单节段经椎弓根椎体截骨术治疗20例强直性脊柱炎后凸畸形患者.术前、术后均行胸腰椎X线检查,评定胸腰段Cobb角矫正情况、植骨愈合情况、临床疗效、内固定位置及手术并发症.结果 无术中死亡及术后感染,术中2例患者硬膜破裂,术后1例患者麻痹性肠梗阻,2例出现短暂不全瘫.随访15～60个月,后凸畸形均获明显矫正,胸腰段Cobb角平均矫正35.6°,矫正前后有显著性差异(P＜0.05).末次随访无内固定断裂、脱出,均达骨性融合.结论 单节段经椎弓根椎体截骨术治疗强直性脊柱脊柱后凸畸形,矫形效果及临床疗效满意.