PDF(Pubmed)
Abstract：
UNASSIGNED: Advanced ankylosing spondylitis is often associated with thoracolumbar kyphosis, resulting in an abnormal spinopelvic balance and pelvic morphology. Different osteotomy techniques have been used to correct AS deformities, unfortunnaly, not all AS patients can gain spinal sagittal balance and good horizontal vision after osteotomy.
UNASSIGNED: Fourteen consecutive AS patients with severe thoracolumbar kyphosis who were treated with two-level PSO were studied retrospectively. All were male with a mean age of 34.9 ± 9.6 years. The followup ranged from 1-5 years. Preoperative computer simulations using the Surgimap Spinal software were performed for all patients, and the osteotomy level and angle determined from the computer simulation were used surgically. Spinal sagittal parameters were measured preoperatively, after the computer simulation, and postoperatively and included thoracic kyphosis (TK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence, pelvic tilt (PT), and sacral slope (SS). The level of correlation between the computer simulation and postoperative parameters was evaluated, and the differences between preoperative and postoperative parameters were compared. The visual analog scale (VAS) for back pain and clinical outcome was also assessed.
UNASSIGNED: Six cases underwent PSO at L1 and L3, five cases at L2 and T12, and three cases at L3 and T12. TK was corrected from 57.8 ± 15.2° preoperatively to 45.3 ± 7.7° postoperatively (P < 0.05), LL from 9.3 ± 17.5° to -52.3 ± 3.9° (P < 0.001), SVA from 154.5 ± 36.7 to 37.8 ± 8.4 mm (P < 0.001), PT from 43.3 ± 6.1° to 18.0 ± 0.9° (P < 0.001), and SS from 0.8 ± 7.0° to 26.5 ± 10.6° (P < 0.001). The LL, VAS, and PT of the simulated two-level PSO were highly consistent with, or almost the same as, the postoperative parameters. The correlations between the computer simulations and postoperative parameters were significant. The VAS decreased significantly from 6.1 ± 1.9 to 2.0 ± 1.1 (P < 0.001). In terms of clinical outcome, 10 cases were graded \"excellent\" and 4 cases were graded \"good.\"
UNASSIGNED: Two-level PSO using a preoperative computer simulation is a feasible, safe, and effective technique for the treatment of severe thoracolumbar kyphosis in AS patients with normal cervical motion.
UNASSIGNED: Fourteen consecutive AS patients with severe thoracolumbar kyphosis who were treated with two-level PSO were studied retrospectively. All were male with a mean age of 34.9 ± 9.6 years. The followup ranged from 1-5 years. Preoperative computer simulations using the Surgimap Spinal software were performed for all patients, and the osteotomy level and angle determined from the computer simulation were used surgically. Spinal sagittal parameters were measured preoperatively, after the computer simulation, and postoperatively and included thoracic kyphosis (TK), lumbar lordosis (LL), sagittal vertical axis (SVA), pelvic incidence, pelvic tilt (PT), and sacral slope (SS). The level of correlation between the computer simulation and postoperative parameters was evaluated, and the differences between preoperative and postoperative parameters were compared. The visual analog scale (VAS) for back pain and clinical outcome was also assessed.
UNASSIGNED: Six cases underwent PSO at L1 and L3, five cases at L2 and T12, and three cases at L3 and T12. TK was corrected from 57.8 ± 15.2° preoperatively to 45.3 ± 7.7° postoperatively (P < 0.05), LL from 9.3 ± 17.5° to -52.3 ± 3.9° (P < 0.001), SVA from 154.5 ± 36.7 to 37.8 ± 8.4 mm (P < 0.001), PT from 43.3 ± 6.1° to 18.0 ± 0.9° (P < 0.001), and SS from 0.8 ± 7.0° to 26.5 ± 10.6° (P < 0.001). The LL, VAS, and PT of the simulated two-level PSO were highly consistent with, or almost the same as, the postoperative parameters. The correlations between the computer simulations and postoperative parameters were significant. The VAS decreased significantly from 6.1 ± 1.9 to 2.0 ± 1.1 (P < 0.001). In terms of clinical outcome, 10 cases were graded \"excellent\" and 4 cases were graded \"good.\"
UNASSIGNED: Two-level PSO using a preoperative computer simulation is a feasible, safe, and effective technique for the treatment of severe thoracolumbar kyphosis in AS patients with normal cervical motion.
摘要：
■晚期强直性脊柱炎通常与胸腰椎后凸有关，导致脊柱骨盆平衡和骨盆形态异常。不同的截骨技术已被用于矫正AS畸形，不幸的是,并非所有AS患者在截骨后都能获得脊柱矢状面平衡和良好的水平视力。
■回顾性研究了14例接受两级PSO治疗的严重胸腰椎后凸的AS患者。全部为男性,平均年龄34.9±9.6岁。随访1-5年。使用Surgimap脊柱软件对所有患者进行术前计算机模拟，从计算机模拟中确定的截骨水平和角度被用于手术。术前测量脊柱矢状面参数，在计算机模拟之后,术后包括胸椎后凸畸形（TK），腰椎前凸(LL),矢状垂直轴(SVA),骨盆发病率,骨盆倾斜(PT),和骶骨斜率（SS）。评估了计算机模拟与术后参数之间的相关性水平，并比较术前、术后参数的差异。还评估了背痛和临床结果的视觉模拟量表（VAS）。
■6例在L1和L3行PSO，5例在L2和T12行PSO，3例在L3和T12行PSO。TK由术前57.8±15.2°校正至术后45.3±7.7°(P<0.05),LL从9.3±17.5°到-52.3±3.9°（P<0.001），SVA从154.5±36.7到37.8±8.4mm（P<0.001），PT从43.3±6.1°到18.0±0.9°（P<0.001），SS由0.8±7.0°降至26.5±10.6°(P<0.001)。LL,VAS,模拟的两级PSO的PT与，或者几乎一样，术后参数。计算机模拟与术后参数之间的相关性显着。VAS从6.1±1.9显著降低至2.0±1.1(P<0.001)。就临床结果而言，10例“优”级，4例“良”级。\"
■使用术前计算机模拟的两级PSO是可行的，安全,是治疗颈椎运动正常的AS患者严重胸腰椎后凸畸形的有效技术。
■回顾性研究了14例接受两级PSO治疗的严重胸腰椎后凸的AS患者。全部为男性,平均年龄34.9±9.6岁。随访1-5年。使用Surgimap脊柱软件对所有患者进行术前计算机模拟，从计算机模拟中确定的截骨水平和角度被用于手术。术前测量脊柱矢状面参数，在计算机模拟之后,术后包括胸椎后凸畸形（TK），腰椎前凸(LL),矢状垂直轴(SVA),骨盆发病率,骨盆倾斜(PT),和骶骨斜率（SS）。评估了计算机模拟与术后参数之间的相关性水平，并比较术前、术后参数的差异。还评估了背痛和临床结果的视觉模拟量表（VAS）。
■6例在L1和L3行PSO，5例在L2和T12行PSO，3例在L3和T12行PSO。TK由术前57.8±15.2°校正至术后45.3±7.7°(P<0.05),LL从9.3±17.5°到-52.3±3.9°（P<0.001），SVA从154.5±36.7到37.8±8.4mm（P<0.001），PT从43.3±6.1°到18.0±0.9°（P<0.001），SS由0.8±7.0°降至26.5±10.6°(P<0.001)。LL,VAS,模拟的两级PSO的PT与，或者几乎一样，术后参数。计算机模拟与术后参数之间的相关性显着。VAS从6.1±1.9显著降低至2.0±1.1(P<0.001)。就临床结果而言，10例“优”级，4例“良”级。\"
■使用术前计算机模拟的两级PSO是可行的，安全,是治疗颈椎运动正常的AS患者严重胸腰椎后凸畸形的有效技术。
