强直性脊柱炎腰椎闭合楔形截骨术后的功能转归
Functional outcome after lumbar closing wedge osteotomy in ankylosing spondylitis.
作者信息
Brox Jens Ivar, Helle Arthur, Sørensen Roger, Gunderson Ragnhild, Riise Rolf, Reikerås Olav
机构信息
Department of Orthopedics, Rikshospitalet University Hospital and Medical Faculty, University of Oslo, Oslo, Norway.
出版信息
Int Orthop. 2009 Aug;33(4):1049-53. doi: 10.1007/s00264-008-0590-3. Epub 2008 May 28.
This study entails a prospective evaluation of lumbar closing wedge osteotomy for correction of thoracolumbar kyphotic deformity in ankylosing spondylitis. Twenty patients with a median age of 52 years (range, 26-70) underwent follow-up at one year. The lumbar closing wedge osteomtomy was stabilised by metallic rods fixed by transpedicular screws. Outcome measures were quality of life (EuroQol), occiput-to-wall distance, pain, fatigue, complications, technical and radiological evaluation. The technical result was good in 16 and fair in four patients; two had neuropraxia. The deformity was reduced an average of 17 degrees (95% confidence interval 15-25 degrees) at one-year follow-up. Pain during activity, pain at night, and fatigue were significantly reduced. EuroQol improved from 0.42 to 0.69 (p = 0.002) and occiput-to-wall distance from 26 to 18 cm (p = 0.005). Functional outcome was improved after lumbar closing wedge osteotomy in ankylosing spondylitis.
本研究对腰椎闭合楔形截骨术矫正强直性脊柱炎胸腰椎后凸畸形进行了前瞻性评估。20例患者，中位年龄52岁（范围26 - 70岁），接受了为期一年的随访。腰椎闭合楔形截骨术通过经椎弓根螺钉固定的金属棒进行稳定。结果测量指标包括生活质量（欧洲五维度健康量表）、枕墙距、疼痛、疲劳、并发症、技术及影像学评估。16例患者技术结果良好，4例一般；2例出现神经失用。在一年的随访中，畸形平均矫正17度（95%置信区间15 - 25度）。活动时疼痛、夜间疼痛及疲劳均显著减轻。欧洲五维度健康量表评分从0.42提高至0.69（p = 0.002），枕墙距从26厘米缩短至18厘米（p = 0.005）。强直性脊柱炎患者行腰椎闭合楔形截骨术后功能结局得到改善。
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