Department of Orthopaedic Surgery, Guri Hospital, Hanyang Universtiy College of Medicine, Guri, Korea.
Clin Orthop Surg. 2010 Dec;2(4):209-13. doi: 10.4055/cios.2010.2.4.209. Epub 2010 Nov 5.
Patients with ankylosing spondylitis (AS) achieve early bone union compared to those with other spinal diseases. This study compared the time to bone union after surgery between AS patients and degenerative spinal disease patients.
Patients with degenerative spinal diseases (control group) and AS (experimental group) underwent pedicle subtraction osteotomy followed by posterolateral fusion, and decompression and posterolateral fusion, respectively. There were 10 patients in the experimental group. The control group included 26 patients who were less than 50 years of age and underwent two-level autogenous grafting after decompression and spinal fusion. Autogenous grafts and a range of bone substitutes were used in the experimental group, whereas only autogenous grafts were used in the control group. Bone union was determined on the radiographs and 3-dimensional CT scan images. The level of union was assessed using the Lenke's and Christensen's classification systems.
In the experimental group, the mean age was 41.3 years (range, 30 to 67 years), the mean follow-up period was 21.7 months (range, 12 to 43 months), and bone union was confirmed at an average of 3.5 months (range, 3 to 5 months) after surgery. In the control group, the mean age was 43.1 years (range, 35 to 50 years), the mean follow-up period was 21.8 months (range, 12 to 74 months), and bone union was observed at an average of 5.6 months (range, 4 to 12 months) after surgery. The difference in the time to bone union between the two groups was significant (p = 0.023).
The union of grafted bone was obtained earlier in patients with AS than in those with degenerative spinal diseases. Therefore, future studies should examine the factors affecting the early union in AS patients.
与其他脊柱疾病相比，强直性脊柱炎（AS）患者术后更早实现骨融合。本研究比较了 AS 患者与退行性脊柱疾病患者术后骨融合的时间。
退行性脊柱疾病患者（对照组）和 AS 患者（实验组）分别接受经椎弓根截骨术加后路融合、减压加后路融合。实验组有 10 例患者，对照组有 26 例年龄小于 50 岁的患者，在减压和脊柱融合后进行 2 级自体移植物移植。实验组使用自体移植物和多种骨替代物，对照组仅使用自体移植物。通过 X 线片和三维 CT 扫描图像确定骨融合。使用 Lenke 分级系统和 Christensen 分级系统评估融合水平。
实验组患者的平均年龄为 41.3 岁（范围 30 至 67 岁），平均随访时间为 21.7 个月（范围 12 至 43 个月），术后平均 3.5 个月（范围 3 至 5 个月）确认骨融合。对照组患者的平均年龄为 43.1 岁（范围 35 至 50 岁），平均随访时间为 21.8 个月（范围 12 至 74 个月），术后平均 5.6 个月（范围 4 至 12 个月）观察到骨融合。两组间骨融合时间的差异具有统计学意义（p = 0.023）。
与退行性脊柱疾病患者相比，AS 患者的植骨融合更早。因此，未来的研究应探讨影响 AS 患者早期融合的因素。
