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1
Prevalence and Predictors of Pressure Injuries From Spine Surgery in the Prone Position: Do Body Morphological Changes During Deformity Correction Increase the Risks?俯卧位脊柱手术后压力性损伤的发生率及预测因素：畸形矫正过程中身体形态的变化是否会增加风险？
Spine (Phila Pa 1976). 2017 Nov 15;42(22):1730-1736. doi: 10.1097/BRS.0000000000002177.
2
Complications associated with prone positioning in elective spinal surgery.择期脊柱手术中俯卧位相关并发症。
World J Orthop. 2015 Apr 18;6(3):351-9. doi: 10.5312/wjo.v6.i3.351.
3
Pedicle subtraction osteotomy in the cervical spine.脊柱椎弓根切除截骨术。
Spine (Phila Pa 1976). 2012 Mar 1;37(5):E342-8. doi: 10.1097/BRS.0b013e318245bcd4.
4
Increased mortality in ankylosing spondylitis is related to disease activity.强直性脊柱炎患者死亡率增高与疾病活动度相关。
Ann Rheum Dis. 2011 Nov;70(11):1921-5. doi: 10.1136/ard.2011.151191. Epub 2011 Jul 21.
5
Surgical management of symptomatic cervical or cervicothoracic kyphosis due to ankylosing spondylitis.强直性脊柱炎所致症状性颈椎或颈胸段后凸的手术治疗
Spine (Phila Pa 1976). 2008 Jul 15;33(16):E559-64. doi: 10.1097/BRS.0b013e31817c6c64.
6
Anaesthesia in the prone position.俯卧位麻醉。
Br J Anaesth. 2008 Feb;100(2):165-83. doi: 10.1093/bja/aem380.
7
C7 decancellisation closing wedge osteotomy for the correction of fixed cervico-thoracic kyphosis.用于矫正固定性颈胸段后凸畸形的C7去松质骨闭合楔形截骨术
Eur Spine J. 2007 Sep;16(9):1471-8. doi: 10.1007/s00586-006-0290-x. Epub 2007 Mar 3.
8
Thirty-six years experience of cervical extension osteotomy in ankylosing spondylitis: techniques and outcomes.强直性脊柱炎颈椎后伸截骨术36年经验：技术与结果
Spine (Phila Pa 1976). 2006 Dec 15;31(26):3006-12. doi: 10.1097/01.brs.0000250663.12224.d9.
9
Cervical osteotomy in ankylosing spondylitis: evaluation of new developments.强直性脊柱炎中的颈椎截骨术：新进展评估
Eur Spine J. 2006 Apr;15(4):493-500. doi: 10.1007/s00586-005-0945-z. Epub 2005 Jun 1.
10
Cervical osteotomy for the correction of chin-on-chest deformity in ankylosing spondylitis. Technical note.颈椎截骨术矫正强直性脊柱炎中的低头畸形。技术说明。
Neurosurg Focus. 2003 Jan 15;14(1):e9. doi: 10.3171/foc.2003.14.1.10.

一种用于强直性脊柱炎胸锁关节畸形俯卧位下辅助延长截骨术的创新系统。

An Innovative System to Facilitate Extension Osteotomy in the Prone Position for Chin-on-Chest Deformity of Ankylosing Spondylitis.

作者信息

Kolb Benjamin, Large John, Smurthwaite Glyn

机构信息

Department of Anaesthesia, Salford Royal NHS Foundation Trust, Salford, UK.

出版信息

Int J Spine Surg. 2020 Dec;14(6):1009-1015. doi: 10.14444/7151. Epub 2020 Dec 29.

DOI:10.14444/7151
PMID:33560262
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7872399/
Abstract

BACKGROUND

In the presence of chin-on-chest deformity of ankylosing spondylitis, positioning for extension osteotomy of the spine is a challenging endeavor. Conventional prone positioning equipment cannot safely accommodate all patients with advanced deformity where the chin brow angle approaches or exceeds 90°. Issues such as inability to accommodate the head and associated equipment while providing operative stability and venous congestion of the head represent significant perioperative risks. The sitting position has been advocated as an alternative but is suboptimal for surgical access and anesthetic care. We present a technical note for a positioning system developed to facilitate extension osteotomy in the prone position.

METHODS

A positioning device was designed to accommodate patients with advanced deformity. A series of patients with chin brow angles of up to 89° were positioned using our new system.

RESULTS

We were able to facilitate safe extension osteotomy in the prone position, for procedures lasting up to 14 hours. All our patients were discharged home without significant complication.

CONCLUSIONS

Our device is simply constructed and may be easily replicated in other institutions engaging in complex spine surgery. We hope our system provides clinicians with greater freedom to provide optimal perioperative care to their patients.

摘要

背景

在强直性脊柱炎导致的下巴贴胸畸形情况下，脊柱伸展截骨术的体位摆放是一项具有挑战性的工作。传统的俯卧位摆放设备无法安全地容纳所有下巴眉角接近或超过90°的晚期畸形患者。诸如在提供手术稳定性的同时无法容纳头部及相关设备以及头部静脉充血等问题代表着重大的围手术期风险。坐位已被提倡作为一种替代方案，但对于手术入路和麻醉护理而言并非最佳选择。我们介绍一种为便于在俯卧位进行伸展截骨术而开发的体位摆放系统的技术说明。

方法

设计了一种体位摆放装置以容纳晚期畸形患者。使用我们的新系统对一系列下巴眉角高达89°的患者进行了体位摆放。

结果

我们能够在俯卧位顺利进行长达14小时的伸展截骨术。我们所有患者均顺利出院，无明显并发症。

结论

我们的装置构造简单，在其他开展复杂脊柱手术的机构中可轻松复制。我们希望我们的系统能为临床医生提供更大的自由度，以便为患者提供最佳的围手术期护理。