van Royen B J, Slot G H
Sint Maartenskliniek, Nijmegen, The Netherlands.
J Bone Joint Surg Br. 1995 Jan;77(1):117-21.
From 1990 to 1993 we treated 22 consecutive patients who had progressive spinal kyphosis due to ankylosing spondylitis by a closing-wedge posterior vertebral osteotomy with partial corporectomy of L4 and transpedicular fixation. The average correction was 32 degrees (24 to 52) with a mean loss of correction after operation of 2.7 degrees (0 to 13). The average operating time was 185 minutes (135 to 240) and blood loss was 2500 ml (1200 to 5000). The osteotomy corrected all patients sufficiently to allow them to see ahead and their posture was improved. There were no fatal complications, but in two cases there was failure of the instrumentation and one patient needed reoperation for nerve compression. Two deep wound infections required removal of the implant and six patients had superficial skin infections under the plaster. The use of a circoelectric bed and intermittent prone lying eliminated this problem.
1990年至1993年期间，我们连续治疗了22例因强直性脊柱炎导致进行性脊柱后凸的患者，采用闭合楔形后路椎体截骨术，同时行L4部分椎体切除术及经椎弓根内固定。平均矫正角度为32度（24度至52度），术后平均矫正度丢失2.7度（0度至13度）。平均手术时间为185分钟（135分钟至240分钟），失血量为2500毫升（1200毫升至5000毫升）。截骨术使所有患者得到了充分矫正，能够向前平视，姿势得到改善。无致命并发症，但有2例内固定失败，1例患者因神经受压需要再次手术。2例深部伤口感染需要取出植入物，6例患者在石膏下出现浅表皮肤感染。使用环电流床和间歇性俯卧位解决了这个问题。
