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1、强直性脊柱炎后凸畸形外科治疗[摘要]目的探讨外科手术治疗强直性脊柱炎后凸畸形的临床疗效。方法选择我院骨科收治的强直性脊柱炎后凸畸形患者38例,按照患者意愿分为两组,多节段截骨组行多节段楔形截骨,单椎体截骨组行椎弓根V型截骨,术后随诊1〜3年,观察所有患者的近期疗效。结果多节段截骨组平均增高(7.4±1.2)cm,手术时间平均(4.2±0.5)h,术中出血平均(2108±106)mL,明显优于单椎体截骨组;随访所有患者均达到骨性融合,无一例感染、瘫痪、死亡等。结论多节段截骨手术治疗强直性脊柱炎后凸畸形疗效确切,可有效改善后凸畸形。[关键词]强直性脊柱炎;后凸畸形;椎弓根椎体楔形截骨;外科治疗
2、[中图分类号]R682.3;R593.23[文献标识码]B[文章编号]1673-9701(2013)32-0139-02AnkylosingspondylitissurgicaltreatmentofafterconvexdeformityLIUYonglWUYe2CAOZheng2GAOErlongl1.SecondDepartmentofSurgery,the731HospitalofChinaAerospaceScienceandIndustryGroup,Beijing100074,China;2.SecondDepartmentofOrthopaedics,thePeople"s
3、LiberationArmyGeneralHospitalFirstAffiliatedHospital,Beijing100048,China[Abstract]ObjectiveToexplorethesurgicaltreatmentofankylosingspondylitistheclinicalcurativeeffectofprotrusiondeformityafter・MethodsChoiceofprotrusiondeformityafterankylosingspondylitispatientsadmittedinourhospitalorthopaedic38c
4、ases,accordingtothewishesaredividedintotwogroups,patientswithmultipiesegmentalbonecuttinggroupslinewedgebonecutting,singlevertebralbodybonecuttinglinegrouppediclev-shapedcutbone,postoperativefollow-upof1to3years,andobserveallpatientswitharecentcurativeeffect・ResultsSegmentalbonecuttinggroupsmorein
5、creasedanaverageof7.4+/一1.2cm,operationtimeonaverage4.2+/~0.5h,intraoperativebleedinganaverageof2108+/T06ml,issuperiortosinglevertebralbodybonecuttinggroups,follow-upofallpatientstoachievebonyfusion,andnoinfection,paralysis,anddeath.ConclusionMultipiesegmentalbonecuttingconvexdeformityaftersurgica
6、ltreatmentofankylosingspondylitiscurativeeffect,caneffectivelyimprovetheprotrusiondeformity._Keywords]Ankylosingspondylitis;Aftertheprotrusiondeformity;Pediclevertebralwedge-shapedbonecutting;Surgicaltreatment强直性脊柱炎是骨科常见的一种慢性炎性疾病,临床表现为紙骼、腰、背、颈疼痛,晚期可出现脊柱后凸畸形,导致患者不能平视,内科保守治疗疗效欠佳。近几年来,外科手术治疗强直性脊柱炎后凸畸
7、形的疗效得到广大患者的肯定,特别是单椎体截骨逐步成熟为多节段截骨,临床疗效更为确切。为探讨外科手术治疗强直性脊柱炎后凸畸形的临床效果,选择2000年至今我院骨科收治的行外科治疗的强直性脊柱炎后凸畸形患者38例,按照患者意愿分为多节段截骨组与单椎体截骨组,现报道如下。1资料与方法1.1一般资料选择2000年至今我院骨科收治的行外科手术治疗强直性脊柱炎后凸畸形患者38例,按照患者意愿分为多节段截骨组20例与单椎体截骨组18例