脊柱多节段截骨术配合Luque棒矫正强直性脊柱炎后凸畸形的初步报告

作者自1985年4月至1987年10月应用脊柱多节段截骨术配合Luque棒矫正强直性脊柱炎后凸畸形12例。其中胸腰后凸11例,腰后凸1例。后凸55～110°(cobb法),平均81°截骨数量为3～7节,平均5.4节。最高截骨平面为T_7,最低L_5。矫正30～80°,平均49.5°,平均矫正率61％。本手术以畸形弧顶为中心分散矫正畸形,具有以下优点:(1)直接矫形符合生物力学原则,可最有效地矫正。(2)可恢复脊柱生理曲线。(3)对脊柱稳定性无影响,多勿须外固定。(4)减少每椎间隙张开,避免血管和内脏过度牵拉。(5)可防止复发。

MULTI-SEGMENTAL POSTERIOR OSTEOTOMY OF SPINE AND LUQUE INSTRUMENTATION FOR CORRECTION OF KYPHOSIS IN ANKYLOSING SPONDYLITIS:A PRELIMINARY REPORT

Multi-segmental posterior osteotomy of the spine was performed upon 12 patients with ankylosing spondylitis for the correction of kyphosis. The deformity was situated in thoraco-lumbar spine in 11 cases and lumbar spine 1 case. The magnitude of the curves ranged from 55 to 110 Cobb's degrees with a mean of 81 degrees. The number of osteotomy was 5.4 in average (3-7 segments). The highest level of osteotomy was T7 and the lowest L5. The average correction was 49.5 degrees (61%) with a range of 30-80 degrees. No severe complication was found in our series. This procedure may disperse the effects of osteotomies over the whole curve with its center at the apex of the curve, and it carries the following advantages: (1) direct correction is mechanically efficient and causes a better external appearence with less correction; (2) it may restore the physiological curves and normal weight-bearing line of the spine; (3) it entails solittle influence on the stability of the spine that it is unnecessary to give extra support; (4) it may reduce the opening up of each intervertebral space, avoiding the overstretching injury of the viscrae and blood vessels.