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[强直性脊柱炎。34例脊柱骨折的治疗及并发症]

[Ankylosing spondylitis. Therapy and complications of 34 spine fractures].

作者信息

Zdichavsky M, Blauth M, Knop C, Lange U, Krettek C, Bastian L

机构信息

Abteilung für Allgemeine Chirurgie, Klinikum der Eberhard-Karls-Universität Tübingen.

出版信息

Chirurg. 2005 Oct;76(10):967-75. doi: 10.1007/s00104-005-1023-0.

Abstract

BACKGROUND

Spine fractures in ankylosing spondylitis (AS) are extremely unstable and associated with a high complication rate. The aim of this retrospective study was to evaluate the therapy and complications of these fractures in AS for a better understanding and management.

PATIENTS AND METHODS

A total of 32 patients with 34 traumatic spine fractures were treated from 1981 to 2002. Cause of trauma, fracture site, and neurological examination were assessed. Analyses of the management of the treatment and complications were performed.

RESULTS

Banal traumas resulted mostly in spinal fractures at the C 5/6 and C 6/7 level. Two patients were treated conservatively, while the others were stabilized operatively. Before therapy was undertaken, six patients suffered from a cervical radiculopathy, ten patients had an incomplete and two a complete paraplegia. After therapy, neurological status improved in eight patients, but one had a deterioration of neurological symptoms.

CONCLUSIONS

Dorsal or combined dorsoventral stabilization of these fractures is necessary for better mobilization of these patients and to avoid further complications.

摘要

背景

强直性脊柱炎(AS)患者的脊柱骨折极不稳定,且并发症发生率高。这项回顾性研究的目的是评估AS患者脊柱骨折的治疗方法及并发症,以便更好地理解和处理此类骨折。

患者与方法

1981年至2002年间共治疗了32例患者的34处创伤性脊柱骨折。评估了创伤原因、骨折部位及神经学检查情况,并对治疗管理及并发症进行了分析。

结果

轻微创伤多导致C5/6和C6/7水平的脊柱骨折。2例患者接受保守治疗,其余患者接受手术固定。治疗前,6例患者患有颈神经根病,10例患者不完全截瘫,2例患者完全截瘫。治疗后,8例患者神经状态改善,但1例患者神经症状恶化。

结论

对这些骨折进行后路或前后联合固定,对于改善这些患者的活动能力及避免进一步并发症是必要的。

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