Farrokhi Majid Reza, Nazarinia Mohammadali, Eghbal Keyvan, Nouraei Hormoz, Liaghat Alireza, Motlagh Mohammadhadi Amir Shahpari, Yousefi Omid, Mousavi Seyed Reza
Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran.
Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Neurosurg Rev. 2025 Feb 19;48(1):252. doi: 10.1007/s10143-025-03406-3.
Ankylosing Spondylitis (AS) is a systemic inflammatory disease that involves the axial skeleton the most. It causes ascending inflammation and, thus, rigidity in the spinal column, from the sacroiliac joint to the cervical region. Spinal column deformities, besides vulnerability to trauma, alter the patients' quality of life and put their neural elements a great risk. In this study, we reviewed data of twenty AS patients who underwent spinal surgery due to trauma and spinal deformity due to AS, over 12 years in our center. Spinal radiologic indices, besides clinical evaluation of quality of life and neurologic status, were reviewed and mentioned. AS patients who were operated due to severe deformity and instability, correction of spinopelvic indices correlated with significant improvement in their quality of life and pain scores. Among those who were operated due to fracture and/or neurologic damage, clinical and neurologic improvement was significant. Spinal trauma and mal-alignment is AS, correlates with neurological compromise, and clinical symptoms such as pain and gait disturbance. Near complete correction of these indices improves patients' quality of life. Traumatic spinal fractures in AS, should be considered unstable unless otherwise proved. Meticulous surgical stabilization in such cases usually indicates.
强直性脊柱炎（AS）是一种主要累及中轴骨骼的全身性炎症性疾病。它会引发上行性炎症，进而导致脊柱从骶髂关节到颈椎区域出现僵硬。脊柱畸形不仅会增加患者遭受创伤的风险，还会改变患者的生活质量，并使其神经组织面临极大风险。在本研究中，我们回顾了本中心12年来20例因创伤及AS导致的脊柱畸形而接受脊柱手术的AS患者的数据。除了对生活质量和神经状况进行临床评估外，还对脊柱放射学指标进行了回顾和阐述。因严重畸形和不稳定而接受手术的AS患者，脊柱骨盆指标的矫正与生活质量和疼痛评分的显著改善相关。在因骨折和/或神经损伤而接受手术的患者中，临床和神经功能的改善非常显著。AS患者的脊柱创伤和排列不齐与神经功能损害以及疼痛和步态障碍等临床症状相关。这些指标的近乎完全矫正可改善患者的生活质量。AS患者的创伤性脊柱骨折，除非另有证明，否则应视为不稳定骨折。在这种情况下，通常需要进行细致的手术固定。
