Department of Rehabilitation, The Affiliated Hospital of Qingdao University, Qingdao 266000, China.
Department of Orthopedics, The Affiliated Hospital of Qingdao University, Qingdao 266003, China.
Pain Res Manag. 2022 Mar 4;2022:7769775. doi: 10.1155/2022/7769775. eCollection 2022.
Through the follow-up analysis of cervical spine fracture cases with ankylosing spondylitis (AS), a treatment-oriented fracture classification method is introduced to evaluate the clinical efficacy guided by this classification method.
A retrospective analysis was performed on 128 AS patients who underwent comprehensive treatment in the Spine Surgery Department of Qingdao University Hospital from January 2009 to May 2018. Statistics of patient demographic data, distribution of different fractures corresponding to surgical methods, 3-year follow-up outcomes, and summary of objective fracture classification methods were analyzed. A prospective 5-year follow-up study of 90 patients with AS cervical spine fractures from June 2015 to August 2020 was also included. Statistical differences on the distribution of factors such as case information, cervical spine sagittal sequence parameters, and fracture classification were assessed. Correlations between surgical information, American Spinal Injuries Association grade (ASIA), modified Japanese Orthopaedic Association scores (mJOA), and other factors were analyzed to establish a nomogram predictive model for curative effect outcomes. Overall, three major types and the four subtypes of AS cervical spine fractures were evaluated based on the clinical efficacy of the classification and the selection of surgical treatment methods.
The most common type of fracture was type II (30 cases, 33.33%), most of the subtypes were A (37 cases), followed by B (36 cases) and C (17 cases). Twenty-four of 28 patients with type I underwent anterior surgery, and 47 of 62 patients with type II and III underwent posterior surgery. The average follow-up time was 25.76 ± 11.80 months. The results of predicting clinical variables are different but include factors such as fracture type and subtype, type of operation, and age. The predictor variables include the above-mentioned similar variables, but survival is more affected by the fracture type of the patient.
This predictive model based on follow-up information delineation points out the impact of ankylosing spondylitis cervical spine fracture classification on surgical selection and clinical efficacy.
通过对强直性脊柱炎（AS）伴发颈椎骨折病例的随访分析，引入一种以治疗为导向的骨折分型方法，以此分型方法指导下评估临床疗效。
回顾性分析 2009 年 1 月至 2018 年 5 月在青岛大学附属医院脊柱外科接受综合治疗的 128 例 AS 患者。对患者的人口统计学数据、不同骨折对应的手术方法分布、3 年随访结果以及客观骨折分型方法的总结进行统计学分析。纳入 2015 年 6 月至 2020 年 8 月的 90 例 AS 颈椎骨折前瞻性 5 年随访研究。评估病例信息、颈椎矢状序列参数和骨折分型等因素的分布差异。分析手术信息、美国脊柱损伤协会分级（ASIA）、改良日本矫形协会评分（mJOA）等因素与其他因素之间的相关性，建立预测疗效结果的列线图预测模型。总体上，根据分类的临床疗效和手术治疗方法的选择，对 AS 颈椎骨折的三大主要类型和四大亚型进行评估。
最常见的骨折类型为Ⅱ型（30 例，33.33%），亚型中 A 型（37 例）最常见，其次是 B 型（36 例）和 C 型（17 例）。28 例Ⅰ型患者中有 24 例行前路手术，62 例Ⅱ型和 62 例Ⅲ型患者中有 47 例行后路手术。平均随访时间为 25.76±11.80 个月。预测临床变量的结果不同，但包括骨折类型和亚型、手术类型和年龄等因素。预测变量包括上述类似变量，但患者的骨折类型对生存的影响更大。
该基于随访信息描绘的预测模型指出了强直性脊柱炎颈椎骨折分型对手术选择和临床疗效的影响。
