Shaik Ismail, Bhojraj Shekhar Yeshwant, Prasad Gautam, Nagad Premik Bhupendra, Patel Priyank Mangaldas, Kashikar Aaditya Dattatreya, Kumar Nishant
Department of Spine Surgery, Wockhardt Hospitals Limited, Mumbai, India.
Department of Spine Surgery, Paras HMRI Hospital, Patna, India.
Asian Spine J. 2018 Nov;12(6):1017-1027. doi: 10.31616/asj.2018.12.6.1017. Epub 2018 Oct 16.
This retrospective study was conducted including 18 patients who underwent posterior-only stabilization and fusion procedure for pseudoarthrosis in the ankylosed spine from October 2007 to May 2015.
This study aimed to describe the treatment outcomes in 18 patients with Andersson lesion (AL) who were managed using the posterior-only approach. Literature Review: AL is an unstable, localized, vertebral, or discovertebral lesion of the spine. It is observed in patients with ankylosing spondylitis. The exact etiology of this disorder remains unclear, and the treatment guidelines are not clearly described.
We analyzed 18 patients with AL who were treated with posterior long segment spinal fusion without any anterior interbody grafting or posterior osteotomy. Pre- and postoperative radiography, computed tomography, and recent follow-up images were examined. The pre- and postoperative Visual Analog Scale score and the Oswestry Disability Index score were evaluated for all patients. Whiteclouds' outcome analysis criteria were applied at the follow-up. Moreover, at study completion, patient feedback was collected; all the patients were asked to provide their opinion regarding the surgery and were asked whether they would recommend this procedure to other patients and them self undergo the same procedure again if required.
The most common site was the thoracolumbar junction. The symptom duration ranged from 1 month to 10 years preoperatively. Most patients experienced fusion by the end of 1 year, and the fusion mass could be observed as early as 4 months. Pseudoarthrosis void of up to 2.5 cm was noted to be healed in subsequent imaging. In addition, clinically, the patients reported good symptomatic relief. No patient required revision surgery. Whiteclouds' outcome analysis score at the latest follow-up revealed goodto- excellent outcomes in all patients.
ALs can be treated using the posterior-only approach with long segment fixation and posterior spinal fusion. This is a safe, simple, and quick procedure that prevents the morbidity of anterior surgery.
本回顾性研究纳入了2007年10月至2015年5月期间因强直性脊柱炎假关节而接受单纯后路稳定融合手术的18例患者。
本研究旨在描述18例采用单纯后路手术治疗安德森病变（AL）患者的治疗结果。文献综述：AL是脊柱的一种不稳定、局限性椎体或椎间盘病变。在强直性脊柱炎患者中可见。该疾病的确切病因尚不清楚，治疗指南也未明确描述。
我们分析了18例接受后路长节段脊柱融合术且未进行任何前路椎间植骨或后路截骨术治疗的AL患者。检查了术前和术后的X线片、计算机断层扫描以及近期随访影像。对所有患者评估术前和术后视觉模拟量表评分及奥斯维斯特残疾指数评分。随访时采用白云的疗效分析标准。此外，在研究结束时，收集患者反馈；询问所有患者对手术的看法，以及他们是否会向其他患者推荐该手术，以及如果需要是否会再次接受相同手术。
最常见的部位是胸腰段交界处。术前症状持续时间为1个月至10年。大多数患者在1年末实现融合，最早在4个月时可观察到融合块。在随后的影像学检查中，发现长达2.5 cm的假关节间隙已愈合。此外，临床上患者报告症状明显缓解。无患者需要翻修手术。最新随访时白云的疗效分析评分显示所有患者的结果均为良好至优秀。
AL可采用单纯后路长节段固定和后路脊柱融合术治疗。这是一种安全、简单且快速的手术，可避免前路手术的并发症。
