Hu Wenhao, Yu Jiayi, Liu Huawei, Zhang Xuesong, Wang Yan
Department of Orthopedics, Chinese PLA General Hospital, Beijing, People's Republic of China.
Department of Renal cancer and Melanoma, Peking University Cancer Hospital, Beijing, People's Republic of China.
PLoS One. 2016 Dec 9;11(12):e0167792. doi: 10.1371/journal.pone.0167792. eCollection 2016.
The aim of the study is to evaluate the efficacy of a spinal osteotomy technique, Y shape osteotomy, for correcting kyphosis in AS patients planned preoperatively with computer software-assistance. 36 consecutive AS patients with thoracolumbar kyphosis were treated with one-stage posterior Y shape osteotomy and preoperative surgical planning was done with the aid of the Surgimap Spine. Radiological parameters of simulation and immediate postoperation were documented. Clinical and radiological results were evaluated in the preoperative, the early postoperative periods and during the last follow-up. The lumbar lordosis was found as 40.7 ± 4.1 degrees in the surgical planning and 49.7 ± 3.9 degrees postoperatively (p<0.01). PI-LL was 3.8± 0.9°in the simulation procedure and 6.6± 1.5°postoperatively (p<0.01). At the final follow-up, Global sagittal balance was restored and Both Oswestry Disability Index and Scoliosis Research Society scores improved largely. In conclusion, Y shape osteotomy is a safe and effective treatment option for AS patients with kyphosis deformity.
本研究的目的是评估一种脊柱截骨技术——Y形截骨术,在计算机软件辅助下对术前计划的强直性脊柱炎(AS)患者矫正后凸畸形的疗效。连续36例胸腰椎后凸畸形的AS患者接受了一期后路Y形截骨术,并借助Surgimap Spine软件进行术前手术规划。记录模拟和术后即刻的影像学参数。在术前、术后早期和最后随访期间评估临床和影像学结果。手术规划时腰椎前凸为40.7±4.1度,术后为49.7±3.9度(p<0.01)。模拟过程中PI-LL为3.8±0.9°,术后为6.6±1.5°(p<0.01)。在最后随访时,整体矢状面平衡得以恢复,奥斯威斯利功能障碍指数和脊柱侧弯研究学会评分均有显著改善。总之,Y形截骨术是治疗AS后凸畸形患者的一种安全有效的治疗选择。