摘要
目的探讨颌眉角在强直性脊柱炎伴僵硬性胸腰椎后凸畸形矫形手术中的意义。方法回顾性分析自2008-08—2013-06行截骨矫形术的32例强直性脊柱炎伴胸腰椎后凸畸形,根据颌眉角确定截骨角度。比较术前及末次随访时的疼痛视觉模拟评分（VAS）、Oswestry功能障碍指数（ODI）、颌眉角、矢状面平衡（SVA）、腰椎前凸角（LL）、骨盆倾斜角（PT）。结果本组手术时间160~280 min,平均210 min;术中失血量650~1 600 ml,平均850 ml。32例均获得平均28（19~37）个月随访。所有患者的影像资料显示截骨平面之间有骨小梁通过,动力位上无活动,均达到骨性融合。除2例出现间断性腰痛外,其他患者均无明显临床症状。末次随访时的VAS评分、ODI指数、颌眉角、SVA、LL及PT均较术前明显改善,差异有统计学意义（P〈0.05）。结论颌眉角有助于指导强直性脊柱炎伴胸腰椎后凸畸形后路截骨矫形术中截骨角度的确定。
Objective To investigate the significance of chin brow vertical angle（CBVA） in osteotomy correction of ankylosing spondylitis （AS） with thoracolumbar kyphotic deformity. Methods From August 2008 to June 2013, 32 cases of AS with thoracolumhar kyphotic deformity underwent orthopedic surgery, and the osteotomy angle （OA） were determined by pro- operative CBVA. The preoperative visual analogue scale （VAS）, Oswestry disability index （ODI）, CBVA, lumber lordosis（LL）, sagittal vertical axis（SVA） and pelvic tilt（PT） with last follow-up were compared. Results The mean operative time was 210 min （range 160-280 min）. The mean blood loss was 850 ml （range 650-1 600 ml）. The mean follow-up was 28 months（range 19-37 months）. All the patients achieved bone healing with bone trabecular passing 0steotomy plane. There was excellent outcome in all patients except 2 patients with low back pain. The VAS, ODI, CBVA, LL, SVA and PT in last follow-up all demonstrated statistically significant improvement compared with preoperative status （P 〈0.05）. Conclusion CBVA helps to determine the osteotomy angle at L3 for the cases of AS with thoracolumbar kyphotic deformity.
作者
梁鹏展
陈晓东
翟明玉
赵海博
李全修
LIANG Peng-zhan CHEN Xiao-dong ZHAI Ming-yu ZHAO Hai-bo LI Quan-xiu(Department of Spinal Surgery, the Shenzhen Pingle Orthopedic Hospital, Shenzhen, Guangdong 518010, China)
出处
《中国骨与关节损伤杂志》
2016年第9期915-918,共4页
Chinese Journal of Bone and Joint Injury
关键词
强直性脊柱炎
脊柱后凸
截骨矫形术
颌眉角
Ankylosing spondylitis
Kyphotic deformity
Osteotomy
Chin brow vertical angle
