Abstract：
The objective of this study was to evaluate the surgical effectiveness of posterior procedure with long segment stabilization for treating thoracolumbar pseudarthrosis associated with ankylosing spinal disorders (ASDs) without anterior fusion or osteotomy.
Twelve patients with thoracolumbar pseudarthrosis in ASD were enrolled. All patients underwent posterior long-segment stabilization procedures. In some patients, the percutaneous technique or the aid of a robot or O-arm navigation was utilized for pedicle screw implantation. The clinical results were evaluated by means of the visual analog scale and Oswestry Disability Index. Radiological outcomes were evaluated for bone fusion, anterior column defect, local kyphotic correction, and position of the pedicle screws.
All patients experienced effective bone fusion at the sites of pseudarthrosis. The mean operative time was 161.7 ± 57.1 minutes, and the average amount of blood loss was 305.8 ± 293.2 mL. For 6 patients who underwent surgery with the assistance of a robot or O-arm navigation, there was no statistically significant difference observed in terms of operative time and mean blood loss compared to those who used the freehand technique (P > 0.05). The visual analog scale score, Oswestry Disability Index value, and mean local kyphotic angle showed significant improvements at the final follow-up (P < 0.05). The accuracy of pedicle screw placement was 96%.
Posterior surgery with long-segment fixation, without anterior fusion or osteotomy, can achieve satisfactory outcomes in ASD patients with thoracolumbar pseudarthrosis. The application of percutaneous techniques, as well as the assistance of robots or navigation technique may be a good choice for the treatment of pseudarthrosis in ASD patients.
Twelve patients with thoracolumbar pseudarthrosis in ASD were enrolled. All patients underwent posterior long-segment stabilization procedures. In some patients, the percutaneous technique or the aid of a robot or O-arm navigation was utilized for pedicle screw implantation. The clinical results were evaluated by means of the visual analog scale and Oswestry Disability Index. Radiological outcomes were evaluated for bone fusion, anterior column defect, local kyphotic correction, and position of the pedicle screws.
All patients experienced effective bone fusion at the sites of pseudarthrosis. The mean operative time was 161.7 ± 57.1 minutes, and the average amount of blood loss was 305.8 ± 293.2 mL. For 6 patients who underwent surgery with the assistance of a robot or O-arm navigation, there was no statistically significant difference observed in terms of operative time and mean blood loss compared to those who used the freehand technique (P > 0.05). The visual analog scale score, Oswestry Disability Index value, and mean local kyphotic angle showed significant improvements at the final follow-up (P < 0.05). The accuracy of pedicle screw placement was 96%.
Posterior surgery with long-segment fixation, without anterior fusion or osteotomy, can achieve satisfactory outcomes in ASD patients with thoracolumbar pseudarthrosis. The application of percutaneous techniques, as well as the assistance of robots or navigation technique may be a good choice for the treatment of pseudarthrosis in ASD patients.
摘要：
目的：评价后路长节段稳定术治疗无前路融合或截骨的强直性脊柱疾病（ASD）相关胸腰椎假关节的手术效果。
方法：纳入12例ASD的胸腰椎假关节患者。所有患者均接受了后路长段稳定手术。在一些患者中，经皮技术或机器人或O形臂导航的辅助被用于椎弓根螺钉植入.通过视觉模拟评分（VAS）和Oswestry残疾指数（ODI）评估临床结果。评估骨融合的放射学结果，前柱缺损,局部后凸矫正（LK）和椎弓根螺钉的位置。
结果：所有患者在假关节部位均经历了有效的骨融合。平均手术时间161.7±57.1分钟,平均失血量为305.8±293.2ml。对于六名在机器人或O形臂导航的帮助下接受手术的患者，与使用徒手技术的患者相比，手术时间和平均失血量无统计学意义（P>0.05）。VAS评分,ODI值,末次随访时,平均LK角有明显改善(P<0.05)。椎弓根螺钉置入的准确率为96%。
结论：长节段固定的后路手术，没有前路融合或截骨术，ASD合并胸腰椎假关节的患者可以取得满意的疗效。经皮技术的应用，以及机器人或导航技术的辅助可能是治疗ASD患者假关节的好选择。
方法：纳入12例ASD的胸腰椎假关节患者。所有患者均接受了后路长段稳定手术。在一些患者中，经皮技术或机器人或O形臂导航的辅助被用于椎弓根螺钉植入.通过视觉模拟评分（VAS）和Oswestry残疾指数（ODI）评估临床结果。评估骨融合的放射学结果，前柱缺损,局部后凸矫正（LK）和椎弓根螺钉的位置。
结果：所有患者在假关节部位均经历了有效的骨融合。平均手术时间161.7±57.1分钟,平均失血量为305.8±293.2ml。对于六名在机器人或O形臂导航的帮助下接受手术的患者，与使用徒手技术的患者相比，手术时间和平均失血量无统计学意义（P>0.05）。VAS评分,ODI值,末次随访时,平均LK角有明显改善(P<0.05)。椎弓根螺钉置入的准确率为96%。
结论：长节段固定的后路手术，没有前路融合或截骨术，ASD合并胸腰椎假关节的患者可以取得满意的疗效。经皮技术的应用，以及机器人或导航技术的辅助可能是治疗ASD患者假关节的好选择。
