McMaster M J
Princess Margaret Rose Orthopaedic Hospital, Edinburgh, Scotland.
J Bone Joint Surg Br. 1997 Mar;79(2):197-203. doi: 10.1302/0301-620x.79b2.7095.
Fifteen patients with ankylosing spondylitis who had developed a severe flexion deformity of the cervical spine which restricted their field of vision to their feet, were treated by an extension osteotomy at the C7/T1 level. The operation was performed under general anaesthesia with the patient in the prone position and wearing a halo-jacket. Three had internal fixation using a Luque rectangle and wiring. Their mean age was 48 years. Before operation the mean cervical kyphosis was 23 degrees; this was corrected to a mean of 31 degrees of lordosis, a mean correction of 54 degrees. All the patients were able to see straight ahead. One patient with normal neurology soon after operation became quadriparetic after one week; two others had unilateral palsy of the C8 root, which improved. There was subluxation at the site of osteotomy in four patients, and two of them developed a pseudarthrosis which required an anterior fusion.
15例强直性脊柱炎患者出现严重的颈椎屈曲畸形，视野受限至只能看到自己的脚，他们接受了C7/T1水平的伸展截骨术治疗。手术在全身麻醉下进行，患者俯卧位并佩戴头环背心。3例使用Luque矩形和钢丝进行内固定。他们的平均年龄为48岁。术前颈椎平均后凸为23度；术后矫正至平均前凸31度，平均矫正54度。所有患者都能直视前方。1例术后神经功能正常的患者在1周后出现四肢瘫；另外2例出现C8神经根单侧麻痹，但有所改善。4例患者在截骨部位出现半脱位，其中2例形成假关节，需要前路融合。
