Min Yang, Hui-Yun Gu, Hou-Cheng Zhong, Yuan-Long Xie, Wei Jin, Lin Cai, Ren-Xiong Wei
Department of spine, Zhongnan Hospital of Wuhan University, Donghu Road NO.169, Wuhan, Hubei, 430071, People's Republic of China.
BMC Surg. 2019 Jul 26;19(1):99. doi: 10.1186/s12893-019-0565-x.
Ankylosing spondylitis (AS) is a chronic inflammatory disease that primarily affects spine and paraspinal soft tissue. Ankylosing spondylitis is one of the causes of osteoporosis and patients with ankylosing spondylitis tend to have spinal fractures due to limited mobility and osteoporosis. In recent years, due to the increase in the number of patients with AS, patients with AS and thoracolumbar spine fractures have gradually increased. In the past 1 year, we have treated 3 cases of AS with thoracolumbar spine fractures via simple posterior internal fixation and this paper aims to report its clinic effect.
All the three patients selected had a history of ankylosing spondylitis for nearly 30 years, and one of them developed a thoracolumbar spine fracture after falling when he walked, and the other two developed a thoracolumbar spine fracture without any reason. They were hospitalized for "low back pain" and were diagnosed as fractures after careful physical examination and imaging examinations such as X-ray, CT, and MRI. After the preoperative preparation was completed, all the three patients underwent surgery with simple posterior internal fixation-reduction of the fracture and pedicle screw fixation via posterior approach. All the implants-pedicle screws and connecting rods-are made of titanium alloy. For postoperative management, we asked all the patients to stay in bed for 3 weeks after the operation, and then slowly move down with the help of crutches. Fracture healing and neurological function recovery were observed postoperatively. All the three patients recovered satisfactorily after surgery, and the follow-up confirmed that the fracture healed successfully after 3 months.
The 3 patients included 2 men and 1 women. All the 3 patients recovered well after surgery, and the follow-up confirmed that the fracture healed successfully after 3 months. One man developed urination dysfunction after operation and recovered to normal 3 months after rehabilitation exercise.
强直性脊柱炎（AS）是一种主要影响脊柱和椎旁软组织的慢性炎症性疾病。强直性脊柱炎是骨质疏松症的病因之一，强直性脊柱炎患者由于活动受限和骨质疏松症，容易发生脊柱骨折。近年来，由于AS患者数量的增加，AS合并胸腰椎骨折的患者逐渐增多。在过去1年中，我们通过单纯后路内固定治疗了3例AS合并胸腰椎骨折患者，本文旨在报道其临床疗效。
所选的3例患者均有近30年的强直性脊柱炎病史，其中1例在行走时摔倒后发生胸腰椎骨折，另外2例无任何原因发生胸腰椎骨折。他们因“腰痛”入院，经仔细体格检查及X线、CT、MRI等影像学检查后诊断为骨折。术前准备完成后，3例患者均接受了单纯后路内固定手术——经后路骨折复位及椎弓根螺钉固定。所有植入物——椎弓根螺钉和连接杆——均由钛合金制成。术后管理方面，我们要求所有患者术后卧床3周，然后借助拐杖缓慢下地活动。术后观察骨折愈合及神经功能恢复情况。3例患者术后恢复良好，随访证实3个月后骨折成功愈合。
3例患者中男性2例，女性1例。3例患者术后恢复良好，随访证实3个月后骨折成功愈合。1例男性术后出现排尿功能障碍，经康复锻炼3个月后恢复正常。
