Jiang Dengxu, Zhao Deng, Zhong Rui, Zhang Zhong, Hu Zhengjun
Department of Orthopedics, Affiliated Hospital of Southwest Jiaotong University, The Third People's Hospital of Chengdu, Chengdu, 610031, China.
Sci Rep. 2025 May 5;15(1):15703. doi: 10.1038/s41598-025-98871-7.
The aim of this study was to explore the validity and safety of the combination of one-level pedicle subtraction osteotomy (PSO) and one-level Smith-Petersen osteotomy (SPO) in correcting severe ankylosing spondylitis kyphosis. Twenty-five AS patients undergoing one-level PSO and one-level SPO with a minimum of 2-year follow-up were included. Radiographical analyses included T5-T12 kyphosis (TK), L1-S1 lordosis (LL), global kyphosis (GK), osteotomized vertebral angle (OVA), sagittal vertical axis (SVA) and pelvic parameters. The computed tomographic (CT) scans of the spine were used to measure the aortic diameter and length. Clinical outcomes were evaluated by Oswestry Disability Index (ODI) questionnaire. The mean correction of OVA at PSO level and SPO level was 33.6° ± 9.2° and 26.0° ± 13.2° respectively. An average correction of 69.3° ± 23.2° in GK was achieved. The mean operation time was 372.6 ± 60.1 min and the estimated blood loss averaged 1790.4 ± 953.3 ml. The mean increase of aortic length after surgery was 3.6 cm. An average decrease of 0.25 cm in aortic diameter at the PSO level was observed after surgery. There was no significant difference in aortic diameter at the SPO level between pre- and post-operation. ODI was improved from 30.2 ± 19.3 before surgery to 15.5 ± 13.9 at the last visit. The combination of one-level SPO and one-level PSO could achieve satisfactory correction outcomes in AS patients with severe kyphosis (GK ≥ 80°) needing a correction of > 60°.
本研究的目的是探讨一期经椎弓根截骨术（PSO）联合一期史密斯-彼得森截骨术（SPO）矫正重度强直性脊柱炎后凸畸形的有效性和安全性。纳入了25例行一期PSO联合一期SPO且随访至少2年的强直性脊柱炎患者。影像学分析包括T5-T12后凸（TK）、L1-S1前凸（LL）、整体后凸（GK）、截骨椎体角度（OVA）、矢状垂直轴（SVA）和骨盆参数。采用脊柱计算机断层扫描（CT）测量主动脉直径和长度。通过Oswestry功能障碍指数（ODI）问卷评估临床疗效。PSO水平和SPO水平的OVA平均矫正角度分别为33.6°±9.2°和26.0°±13.2°。GK平均矫正69.3°±23.2°。平均手术时间为372.6±60.1分钟，估计平均失血量为1790.4±953.3毫升。术后主动脉长度平均增加3.6厘米。术后观察到PSO水平主动脉直径平均减小0.25厘米。SPO水平术前和术后主动脉直径无显著差异。ODI从术前的30.2±19.3改善至末次随访时的15.5±13.9。一期SPO联合一期PSO对需要矫正>60°的重度后凸畸形（GK≥80°）的强直性脊柱炎患者可取得满意的矫正效果。
