Thiranont N, Netrawichien P
Department of Orthopedic Surgery, Faculty of Medicine, Chiang Mai University, Thailand.
Spine (Phila Pa 1976). 1993 Dec;18(16):2517-22. doi: 10.1097/00007632-199312000-00023.
Limitation of movement of the back, pelvis, chest wall, and other joints are the consequences of ankylosing spondylitis. The most serious problem is severe kyphosis leading to disturbance of the activities of daily living and failure of the respiratory system. Transpedicular decancellation closing wedge vertebral osteotomy, using the posterior approach followed by segmental spinal instrumentation, is a safe and easy technique for correction of the deformity. The authors report the results of this technique in six patients, five men and one woman, who had undergone the operation. The average age of the patients was 29.8 years (range 21-38). Three patients had thoracolumbar kyphosis averaging 104 degrees (range, 80-120), while the others had lumbar kyphosis averaging 46.7 degrees (range, 35-60). The angles of correction in all cases average 33 degrees. Only one case in this report had dura tear due to adhesion between the dura and the ossified ligamentum flavum, which required exploration and repairing with myofascial graft. No case had any neurologic complication. At an average of 24 months' follow-up, all cases had improvement of their general appearance, posture, respiratory and gastrointestinal functions, and had good bony union.
背部、骨盆、胸壁及其他关节活动受限是强直性脊柱炎的后果。最严重的问题是严重驼背，导致日常生活活动障碍及呼吸系统功能衰竭。经椎弓根去皮质闭合楔形椎体截骨术，采用后路手术并辅以节段性脊柱内固定，是一种安全且简便的矫正畸形的技术。作者报告了该技术应用于6例接受手术患者（5例男性，1例女性）的结果。患者平均年龄29.8岁（范围21 - 38岁）。3例患者为胸腰椎驼背，平均角度为104度（范围80 - 120度），其余患者为腰椎驼背，平均角度为46.7度（范围35 - 60度）。所有病例的矫正角度平均为33度。本报告中仅1例因硬脊膜与骨化的黄韧带粘连导致硬脊膜撕裂，需进行探查并用肌筋膜移植修复。无病例发生任何神经并发症。平均随访24个月时，所有病例的整体外观、姿势、呼吸及胃肠功能均有改善，且骨愈合良好。
