Polysegmental lumbar posterior wedge osteotomies for correction of kyphosis in ankylosing spondylitis

被引：59

作者：

Van Royen B.J. ^{[1
]}

De Kleuver M. ^{[2
]}

Slot G.H. ^{[2
]}

机构：

[1] Department of Orthopaedic Surgery, Free University Hospital, 1081 HV Amsterdam

[2] Department of Orthopaedic Surgery, Sint Maartenskliniek, Nijmegen

来源：

European Spine Journal | 1998年 / 7卷 / 2期

关键词：

Ankylosing spondylitis; Complications; Lumbar spine; Osteotomies;

D O I：

10.1007/s005860050039

中图分类号：

学科分类号：

摘要：

Between 1984 and 1993 we treated 21 consecutive patients who had progressive thoracic kyphosis due to ankylosing spondylitis by polysegmental posterior lumbar wedge osteotomies. In 19 patients we used the Universal Spinal Instrumentation System and in the last 2 patients the H-frame. The average correction in 20 of 21 patients at follow-up was 25.6°(range 0°- 52°), with a mean segmental correction of 9.5°and a mean loss of correction after operation of 10.7°(range 0°-36°). There were no fatal complications, but in one patient no correction could be obtained during surgery and another patient was reoperated due to lack of correction. Breaking out of screws through the pedicle during compressive correction was seen in seven patients. Implant failure, such as breakage of the threaded rods and/or loosening of the junction between the pedicle screw and the rod, occurred in 9 out of 21 patients. Two patients required reoperation at long-term follow-up. Five out of seven deep wound infections required removal of the implant. Polysegmental lumbar wedge osteotomies for correction of progressive thoracic kyphosis in ankylosing spondylitis is only recommended in patients at a mild stage of the disease with mobile discs and in combination with strong instrumentation.

引用

页码：104 / 110

页数：6

共 31 条

[1]

Bradford D.S., Schumacher W.L., Lonstein J.E., Winter R.B., Ankylosing spondylitis: Experience in surgical management of 21 patients, Spine, 12, pp. 238-243, (1987)

[2]

Briggs H., Keats S., Schlesinger P.T., Wedge osteotomy of the spine with bilateral, intervertebral foraminotomy: Correction of flexion deformity in five cases of ankylosing arthritis of spine, J Bone Joint Surg, 29, pp. 1075-1082, (1947)

[3]

Camargo F.P., Cordeiro E.N., Napoli M.M., Corrective osteotomy of the spine in ankylosing spondylitis. Experience with 66 cases, Clin Orthop, 208, pp. 157-167, (1986)

[4]

Chapchal G., Operative treatment of severe kyphosis as the result of Bechterew's disease, Arch Chir Ned, 1, pp. 57-63, (1949)

[5]

Chen P.Q., Correction of kyphotic deformity in ankylosing spondylitis using multiple spinal osteotomy and Zielke's VDS instruments, J Formosan Med Assoc, 87, pp. 692-698, (1988)

[6]

Dwyer A.F., An anterior approach to scoliosis, J West Pac Orthop Assoc, 6, pp. 3-96, (1969)

[7]

Halm H., Metz-Stevenhagen P., Zielke K., Results of surgical correction of kyphotic deformities of the spine in ankylosing spondylitis on the basis of the modified arthritis impact measurement scales, Spine, 20, pp. 1612-1619, (1995)

[8]

Hehne H.J., Zielke K., Die kyphotische Deformität bei Spondylitis ankylosans. Klinik, Radiologie und Therapie, Die Wirbelsäule in Forschung und Praxis, 112, pp. 32-69, (1990)

[9]

Hehne H.J., Zielke K., Bohm H., Polysegmental lumbar osteotomies and transpedicled fixation for correction of long-curved kyphotic deformities in ankylosing spondylitis. Report on 177 cases, Clin Orthop, 258, pp. 49-55, (1990)

[10]

Herbert J.J., Vertebral osteotomy, technique, indications and results, J Bone Joint Surg [Am], 30, pp. 680-689, (1948)

← 1 2 3 4 →