目的 探讨横突间植骨技术应用于强直性脊柱炎(AS)后凸畸形矫正术的临床效果。方法 回顾性分析2021-2023年AS合并脊柱后凸畸形行后路截骨矫正联合横突间植骨的24例患者,评估术后脊柱参数(GK、TK、LL、SVA等)、植骨融合率及并发症发生情况。结果 患者手术顺利,耐受性良好,术后胸椎后凸角(55.50°±16.81°),腰椎前凸角(44.04°±13.77°),全脊柱后凸角(37.29°±17.42°),矢状面偏移(5.49±3.87)cm等参数较术前差异具有统计学意义(P<0.05)。患者均获随访,未发现相关参数明显丢失。无血管、神经损伤,无应力性骨折等并发症;术后植骨融合率达91.6%(22/24),无内固定断裂。结论 横突间植骨可有效增强脊柱稳定性,降低术后矫正丢失风险。
Abstract
Objective To explore the clinical effect of intertransverse bone grafting in the correction surgery for kyphosis deformity in ankylosing spondylitis (AS). Methods A retrospective analysis was conducted on 24 patients with AS combined with kyphosis who underwent posterior osteotomy correction and intertransverse process bone grafting from 2021 to 2023. The postoperative spinal parameters (GK, TK, LL, SVA, etc.), bone graft fusion rate, and complications were evaluated. Results The patients underwent the surgery smoothly and had good tolerance. The postoperative thoracic lordosis angle(55.50°±16.81°), lumbar lordosis angle (44.04°±13.77°), total spinal kyphosis angle (37.29°±17.42°), sagittal plane deviation [(5.49±3.87) cm] and other parameters exhibited statistically significant differences in comparison to the preoperative period (P<0.05). Subsequent follow-up of the patients revealed no substantial decline in the parameters of concern. The absence of complications, including but not limited to vascular and nerve injuries, as well as stress fractures, was noteworthy. The postoperative bone graft fusion rate was 91.6% (22/24), and there were no cases of internal fixation breakage. Conclusions Intertransverse bone grafting can effectively enhance spinal stability and reduce the risk of postoperative correction loss.
关键词
强直性脊柱炎 /
脊柱后凸 /
脊柱截骨术 /
横突间植骨 /
骨融合率
Key words
ankylosing spondylitis /
kyphosis /
spinal osteotomy /
intertransverse bone grafting /
bone fusion rate
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基金
北京市昌平区“科技副总”专项(202501012012);山东省科学技术厅中央引导地方科技发展资金(YDZX2024096);山东省高端医疗器械创新创业共同体2024年创新项目(2024-SGTTXM-002);北京市自然科学基金联合基金昌平重点研究专题(L244016)
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