Sabou Silviu, Mehdian Hossein, Pasku Dritan, Boriani Luca, Quraishi Nasir A
Department of Complex Spine Surgery, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK.
Centre for Spinal Studies and Surgery, Queens Medical Centre Campus of Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH, UK.
Eur Spine J. 2018 Jul;27(7):1586-1592. doi: 10.1007/s00586-018-5530-3. Epub 2018 Feb 22.
Ankylosing spondylitis (AS) can result in severe cervico-thoracic kyphotic deformity (CTKD). Few studies have addressed the relationship between cervico-thoracic osteotomies in AS and health-related quality of life scores. The aim of this study is to evaluate the impact of cervico-thoracic osteotomy (CTO) on improving quality of life for patients with fixed CTKD.
A database of all patients who underwent a CTO for CTKD in patients with AS was created. Data entered into the database consisted of patients' demographics and comorbidities, as well as surgical, clinical and radiological data. The outcome measures used in our study were Neck Disability Index (NDI), EuroQol 5D-5L (EQ-5D-5L) and Visual Analogue Scale. We also measured the following radiological parameters: chin-brow to vertical angle (CBVA), C7-Slope, C2-7 angle, Regional Kyphosis Angle, C2-C7 sagittal vertical axis (SVA) and C7-S1 SVA.
A total of 13 male patients with AS were included in our study. The mean age was 57.5 years (40-74); and mean follow-up was 37.6 months (12-78). Following the C7-T1 osteotomy (10 Smith Peterson Osteotomies and 3 Pedicle Subtraction Osteotomies), NDI improved from a mean of 65.54 (SD 8.95) to a mean of 22.09 (SD 6.99). The EQ-5D-5L improved from a mean of 0.41 (SD 0.16) to 0.86 (SD 0.088). Pre-operative CBVA was on average 54° (40°-75°) and post-operative was 7° (2°-12°). There were no major complications, 1 superficial infection and 5 minor nerve root irritations.
Cervical osteotomy for the management of fixed flexion deformity of cervical spine in ankylosing spondylitis is a safe procedure and can result in restoration of horizontal gaze and sagittal balance with significant improvement of the patient's health-related quality of life. These slides can be retrieved under Electronic Supplementary Material.
强直性脊柱炎（AS）可导致严重的颈胸后凸畸形（CTKD）。很少有研究探讨AS患者颈胸截骨术与健康相关生活质量评分之间的关系。本研究的目的是评估颈胸截骨术（CTO）对改善固定性CTKD患者生活质量的影响。
建立了一个关于所有因CTKD接受CTO手术的AS患者的数据库。录入数据库的数据包括患者的人口统计学和合并症，以及手术、临床和放射学数据。我们研究中使用的结局指标是颈部功能障碍指数（NDI）、欧洲五维健康量表5D-5L（EQ-5D-5L）和视觉模拟量表。我们还测量了以下放射学参数：颏眉角（CBVA）、C7斜率、C2-7角、局部后凸角、C2-C7矢状垂直轴（SVA）和C7-S1 SVA。
本研究共纳入13例男性AS患者。平均年龄为57.5岁（40-74岁）；平均随访时间为37.6个月（12-78个月）。在进行C7-T1截骨术（10例史密斯-彼得森截骨术和3例椎弓根减法截骨术）后，NDI从平均65.54（标准差8.95）改善至平均22.09（标准差6.99）。EQ-5D-5L从平均0.41（标准差0.16）改善至0.86（标准差0.088）。术前CBVA平均为54°（40°-75°），术后为7°（2°-12°）。无重大并发症，1例浅表感染，5例轻度神经根刺激。
强直性脊柱炎颈椎固定性屈曲畸形的颈椎截骨术是一种安全的手术方法，可恢复水平注视和矢状面平衡，显著改善患者的健康相关生活质量。这些幻灯片可在电子补充材料中获取。
