Koller Heiko, Koller Juliane, Mayer Michael, Hempfing Axel, Hitzl Wolfgang
Schön Klinik Nürnberg Fürth, Center for Spinal and Scoliosis Therapies, Europa-Allee 1, 90763, Fürth, Germany.
Department for Orthopedics and Traumatology, Paracelsus Medical University Salzburg, Salzburg, Austria.
Eur Spine J. 2018 Feb;27(Suppl 1):70-100. doi: 10.1007/s00586-017-5421-z. Epub 2017 Dec 30.
This article presents the current concepts of correction of spinal deformity in ankylosing spondylitis (AS) patients. Untreated AS can be a debilitating disease. In a few patients, disease progression results in severe spinal deformity affecting not only the thoracolumbar, but also the cervical spine. Surgery for correction in AS patients has a long history. With the advent of modern instrumentation, standardization of surgical and anesthesiologic techniques, surgical safety and corrective results could be improved and experiences from lumbar osteotomies could be transferred to the cervical spine.
This article presents the current concepts of correction of spinal deformity in AS patients. In particular, questions regarding the localization and number of osteotomies, the optimal surgical target angle as well as planning and prediction of postoperative alignment are discussed.
Insight into recent technical developments, current challenges with correction and geometric analysis of center of rotation (COR) in cervical 3-column osteotomies (3CO) will be presented.
The article should encourage readers to improve surgical correction efficacy and provide a better understanding of correction geometry in 3CO for thoracolumbar and cervical spinal deformities.
本文介绍了强直性脊柱炎（AS）患者脊柱畸形矫正的当前概念。未经治疗的AS可能是一种使人衰弱的疾病。在少数患者中，疾病进展会导致严重的脊柱畸形，不仅影响胸腰椎，还会影响颈椎。AS患者的矫正手术历史悠久。随着现代器械的出现、手术和麻醉技术的标准化，手术安全性和矫正效果得到了改善，腰椎截骨术的经验也可应用于颈椎。
本文介绍了AS患者脊柱畸形矫正的当前概念。特别讨论了截骨的定位和数量、最佳手术目标角度以及术后对线的规划和预测等问题。
将介绍对近期技术发展的见解、当前矫正挑战以及颈椎三柱截骨术（3CO）中旋转中心（COR）的几何分析。
本文应鼓励读者提高手术矫正效果，并更好地理解3CO中胸腰椎和颈椎畸形的矫正几何学。
