Chan F L, Ho E K, Fang D, Hsu L C, Leong J C, Ngan H
Institute of Radiology and Oncology, University Department of Orthopaedic Surgery, Queen Mary Hospital, Hong Kong.
Acta Radiol. 1987 Jul-Aug;28(4):383-8.
Spinal pseudarthrosis is an important mechanical complication in longstanding ankylosing spondylitis. Thirty-five patients with 40 lesions were studied. Three lesions through vertebral bodies resulted from complete fractures. The rest occurred at interspaces, more common at the lower thoracic and upper lumbar segments. Double pseudarthrotic lesions were observed in 5 patients. Progressive osteolysis of the anterior elements was prominent, with variable sclerosis, osteophytes, vacuum phenomenon, subluxation and fragmentation. A posterior element weak link, as a bony break or facet joint non-fusion, was an essential component in every lesion, playing an initiating or perpetuating role in its pathogenesis. Mechanical derangement from trauma, severe round kyphosis, spondylodiscitis, hip disease, spinal operation and unusual activities may be contributing factors. Initial treatment is conservative, but 16 patients required operative stabilisation.
脊柱假关节形成是长期强直性脊柱炎的一种重要机械性并发症。对35例患者的40处病变进行了研究。3处椎体病变由完全骨折导致。其余病变发生在椎间隙，在下胸段和上腰段更为常见。5例患者观察到双假关节病变。前方结构的进行性骨质溶解明显，伴有不同程度的硬化、骨赘、真空现象、半脱位和碎裂。后方结构薄弱环节，如骨质断裂或小关节未融合，是每个病变的重要组成部分，在其发病机制中起启动或持续作用。创伤、严重圆背畸形、脊椎椎间盘炎、髋关节疾病、脊柱手术及异常活动导致的机械性紊乱可能是促成因素。初始治疗为保守治疗，但16例患者需要手术稳定。
