Tokala Devi Prakash, Lam Khai S, Freeman Brian J C, Webb John K
The Centre for Spinal Studies and Surgery, Nottingham University Hospitals NHS Trust, Queen's Medical Centre Campus, Nottingham, NG7 2UH, UK.
Eur Spine J. 2007 Sep;16(9):1471-8. doi: 10.1007/s00586-006-0290-x. Epub 2007 Mar 3.
Our objective is to report on the clinical and radiological outcome following a decancellisation closing wedge osteotomy for the correction of fixed cervico-thoracic kyphosis in patients with ankylosing spondylitis. The only treatment available for severe fixed flexion deformity of the cervical spine in these patients is an extension osteotomy. Traditionally an anterior opening, posterior closing wedge osteotomy is performed with or without internal fixation. We describe a decancellisation closing wedge osteotomy of C7 accompanied by secure segmental internal fixation. Eight patients operated between 1990 and 2003 with mean age of 54 years and minimum follow up of 2 years were retrospectively evaluated. Restoration of normal forward gaze was achieved in all patients. No patient suffered spinal cord injury or permanent nerve root palsy. There was no loss of correction or pseudarthrosis at final follow up. C7 decancellisation closing wedge osteotomy supplemented with secure segmental internal fixation in experienced hands provides a safe and effective treatment for fixed cervico-thoracic kyphosis in patients with ankylosing spondylitis.
我们的目的是报告在强直性脊柱炎患者中，采用去皮质闭合楔形截骨术矫正固定性颈胸段后凸畸形后的临床和影像学结果。对于这些患者颈椎严重固定性屈曲畸形的唯一治疗方法是伸展截骨术。传统上采用前路开口、后路闭合楔形截骨术，可加或不加内固定。我们描述了一种伴有可靠节段性内固定的C7去皮质闭合楔形截骨术。对1990年至2003年间接受手术的8例患者进行回顾性评估，平均年龄54岁，最短随访2年。所有患者均恢复了正常的向前注视。没有患者发生脊髓损伤或永久性神经根麻痹。末次随访时没有矫正丢失或假关节形成。在经验丰富的医生手中，C7去皮质闭合楔形截骨术辅以可靠的节段性内固定，为强直性脊柱炎患者的固定性颈胸段后凸畸形提供了一种安全有效的治疗方法。
