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强直性脊柱炎患者脊柱手术的临床特点和结局。

Clinical features and outcomes of spine surgery in patients with ankylosing spondylitis.

机构信息

Department of Orthopaedic Surgery, Clinical Research Center, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.

Department of Orthopaedic Surgery, Kyushu University Beppu Hospital, Oita, Japan.

出版信息

Mod Rheumatol. 2023 Dec 22;34(1):208-213. doi: 10.1093/mr/roac142.

Abstract

OBJECTIVES

The study aimed to comprehend the clinical features and outcomes of surgical treatments for spinal disorders in patients with ankylosing spondylitis (AS).

METHODS

This retrospective study enrolled patients with AS who underwent spine surgery between 2000 and 2019 in our facility.

RESULTS

Thirteen patients with AS underwent spine surgeries. The mean age was 56.2 years, and the mean disease duration was 25.1 years at the time of surgery. Nine patients had vertebral fracture, two had kyphotic deformity, and two had myelopathy due to the spinal ligament ossification. Fracture cases included five patients with secondary pseudarthrosis/delayed palsy due to conservative treatment failure. Spinal fixation was performed in all patients. Pedicle subtraction osteotomy for kyphosis and laminectomy for myelopathy were also conducted. All patients improved after surgeries. One patient with kyphotic deformity underwent additional surgery of bilateral hip prosthesis, which resulted in better spine alignment. Four cases of perioperative complications were observed.

CONCLUSION

Myelopathy was newly found as the aetiology requiring surgery in patients with AS. This summarized case series could help physicians to identify patients with surgically treatable spinal disorders among patients with AS.

摘要

目的

本研究旨在了解强直性脊柱炎(AS)患者脊柱疾病手术治疗的临床特点和结局。

方法

本回顾性研究纳入了 2000 年至 2019 年期间在我院接受脊柱手术的 AS 患者。

结果

13 例 AS 患者接受了脊柱手术。患者的平均年龄为 56.2 岁,手术时的平均病程为 25.1 年。9 例患者有椎体骨折,2 例有后凸畸形,2 例有脊髓病,原因是脊柱韧带骨化。骨折病例包括 5 例因保守治疗失败而继发假关节/迟发性瘫痪的患者。所有患者均行脊柱固定术。对于后凸畸形的患者,我们还进行了经椎弓根截骨术,对于脊髓病的患者,我们还进行了椎板切除术。所有患者术后均有改善。1 例后凸畸形患者行双侧髋关节假体置换术,以改善脊柱的对线。观察到 4 例围手术期并发症。

结论

本研究中,脊髓病是 AS 患者需要手术治疗的新病因。本病例系列研究有助于医生识别出有手术治疗指征的脊柱疾病患者。

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