摘要
目的探讨肺门-髋轴法(HHAM)预测截骨角度在强直性脊柱炎(AS)胸腰椎后凸畸形单节段经椎弓根截骨术(PSO)中的应用。方法选取行单节段PSO的AS胸腰椎后凸畸形患者116例,随机均分为HHAM组(HHAM法)和对照组(三角函数法)。比较两组影像学检查结果[骨盆倾斜角(PT)、矢状面平衡距离(SVA)、胸腰段后凸角(TLK)、腰椎前凸角(LL)]、脊柱功能Oswestry功能障碍指数(ODI)评分、生活质量脊柱侧凸研究学会22项问卷量表(SRS-22)评分以及手术并发症发生率。结果与术前比较,术后两组PT、SVA、TLK均减小,LL均增加,且HHAM组较对照组改善更为显著(P<0.05)。与术前比较,术后两组患者ODI评分下降,SRS-22评分升高,且HHAM组较对照组改善更为显著(P<0.05)。手术期间至术后12个月,两组总并发症发生率比较差异无显著性(P>0.05)。结论HHAM法预测截骨角度用于指导单节段PSO治疗AS胸腰椎后凸畸形,能有效改善影像学指标,促进脊柱功能恢复,提高患者生活质量。
Aim To explore the application of the hilar-hip axis method(HHAM)in predicting osteotomy angle for single-level pedicle subtraction osteotomy(PSO)in patients with ankylosing spondylitis(AS)and thoracolumbar kyphosis deformity.Methods A total of 116 AS patients with thoracolumbar kyphosis deformity undergoing single-level PSO were randomly divided into the HHAM group(HHAM method)and the control group(trigonometric method).Radiographic parameters(pelvic tilt(PT),sagittal vertical axis(SVA),thoracolumbar kyphosis angle(TLK),lumbar lordosis(LL)),Oswestry disability index(ODI)score,scoliosis research society-22(SRS-22)score,and surgical complication rates were compared between the two groups.Results Compared with preoperative values,both groups showed decreased PT,SVA,and TLK,and increased LL postoperatively,with more significant improvements in the HHAM group(P<0.05).Postoperative ODI scores decreased and SRS-22 scores increased in both groups,with better outcomes in the HHAM group(P<0.05).No significant difference was observed in total complication incidence between the two groups from surgery to 12 months postoperatively(P>0.05).Conclusion The HHAM method for predicting osteotomy angle can effectively improve radiographic parameters,promote spinal function recovery,and enhance quality of life in AS patients with thoracolumbar kyphosis deformity undergoing single-level PSO.
作者
汪琳休
吴伟
王广
WANG Linxiu;WU Wei;WANG Guang(Department of Spinal Surgery,Chengdu BOE Hospital,Chengdu 610200,Sichuan,China)
出处
《中南医学科学杂志》
2025年第4期700-703,共4页
Medical Science Journal of Central South China
基金
成都市科技局重点研发项目(2023-YF21-00037-SN)。
关键词
肺门-髋轴法
截骨角度
经椎弓根截骨
AS
胸腰椎后凸畸形
hilar-hip axis method
osteotomy angle
pedicle subtraction osteotomy
AS
thoracolumbar kyphosis
