Spine Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China; Medical School of Nanjing University, Nanjing, China; Division of Spine Surgery, Department of Orthopaedics, Guangzhou First People's Hospital, School of Medicine, South China of University of Technology, Guangzhou, China.
Spine Surgery, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China.
J Clin Neurosci. 2023 Nov;117:32-39. doi: 10.1016/j.jocn.2023.09.006. Epub 2023 Sep 23.
To investigate the influence of pelvic incidence (PI) on the kyphosis curve patterns and clinical outcomes in ankylosing spondylitis (AS) patients with thoracolumbar kyphosis and to construct a classification of AS according to the PI value for surgical decision-making. 107 AS patients underwent single-level lumbar pedicle subtraction osteotomy (PSO) and finished a minimal of 2-year follow-up. All patients were divided into three groups: low PI (PI ≤ 40°), moderate PI (40° < PI ≤ 60°), and high PI (PI > 60°). Standing lateral radiographs were taken to evaluate the location of kyphotic apex, thoracic kyphosis (TK), lumbar lordosis (LL), C7 sagittal vertical axis (SVA), spino-sacral angle (SSA), global kyphosis (GK), PI, sacral slope (SS), and pelvic tilt (PT). Visual Analogue Scale (VAS) score, Oswestry Disability Index (ODI) and Bath Ankylosing Spondylitis Functional Index (BASFI) were used to evaluate quality of life. Before surgery, a significant difference was shown in the average LL and the mean GK in high PI group was the largest among the three groups. Correction of SVA, GK and LL in high PI group was the smallest among the three group. No significant difference in clinical outcomes was found among the three groups before surgery and at the final follow-up. Regarding the preoperative sagittal profile, the kyphosis curve pattern of moderate PI group is similar to that of low PI group. For AS patients in these two groups, harmonious sagittal alignment can be restored by a single-level PSO. However, the sagittal imbalance is insufficiently realigned by a single-level PSO in a patient with high PI.
为了研究骨盆入射角（PI）对强直性脊柱炎（AS）胸腰椎后凸患者后凸曲线模式和临床结果的影响，并根据 PI 值对 AS 进行分类，以便为手术决策提供依据。107 例 AS 患者接受单节段腰椎经椎弓根截骨术（PSO），并完成至少 2 年的随访。所有患者分为三组：低 PI（PI≤40°）、中 PI（40°<PI≤60°）和高 PI（PI>60°）。站立位侧位 X 线片评估后凸顶点位置、胸曲（TK）、腰椎前凸（LL）、C7 矢状垂直轴（SVA）、脊柱-骶骨角（SSA）、整体后凸（GK）、PI、骶骨倾斜角（SS）和骨盆倾斜角（PT）。视觉模拟评分（VAS）、Oswestry 功能障碍指数（ODI）和 Bath AS 功能指数（BASFI）用于评估生活质量。术前，高 PI 组的平均 LL 差异有统计学意义，且高 PI 组的平均 GK 最大。三组中，高 PI 组 SVA、GK 和 LL 的矫正最小。三组患者术前与末次随访时的临床结果差异均无统计学意义。关于术前矢状位轮廓，中 PI 组的后凸曲线模式与低 PI 组相似。对于这两组患者，单节段 PSO 可恢复矢状面的和谐对线。然而，对于高 PI 患者，单节段 PSO 不能充分矫正矢状面失平衡。
