Correction Osteotomy of Flexion Deformity of Cervical Spine in Ankylosing Spondylitis - A Case Report-

僵直性脊椎炎之發現已有一世紀之久，由於多發生在年輕人且會引起全身性多處關節僵硬變化，病人活動及日常工作因而受到極大限制，早期治療以防止關節變形及藥物治療為主，但是如果已經侵犯到脊椎部份，則可能會造成頸椎和腰椎的彎曲僵硬及變形，病人因此無法挺直抬頭及目視前方。嚴重的病人甚至無法平躺，直立行走，及開口進食，影響日常生活甚劇；此種病人可以脊椎切骨術來治療，惟開刀危險性頗高。國內過去向沒有類似病人頸椎治療的文獻。我們根據過去國外諸多學者的建議，在病人接受過雙側髖關節及腰椎切骨術之後，嘗試使用S.S.E.P．監視器，在局部麻醉下，病人採坐姿接受頸椎切骨術，術中一次矯正頸椎的彎曲變形角度。手術裡並不使用內固定器固定而以調整術前的HALO-PELVIS外固定器來固定頸椎切骨處，使用期間約六星期，術後一週即可離床行走。一年半追蹤顯示切骨處已完全癒合，病人能抬頭開口進食，進行日常生活活動，且毫無神經缺損存在。因而提出其手術技術及其爭論之處加以討論報告。

關鍵字

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並列摘要

It is well known that severe flexicn deformities of the spine may occur in patients suffering from ankylosing spondylitis. The prevention of these deformities by early recognition of the disease process should be the main aim of the medical profession in handling patients with specific spinal involvements. Yet, we still see all too often patients with advanced kyphotic deformities of the trunk who are very grossly disabled and thus present a major problem to definitive surgical correction of their deformities. Correction of rigid kyphosis by establishing a compensatory lordosis can be carried out in the lumbar or cervical area. Surgical intervention in the cervical region enables the chin to be lifted off the sternum, but great care has to be taken of the relatively bulky spinal cord, which practically fills the spinal canal. Excessive correction runs the risks of fatally damaging the nerves and vertebral vessels. Therefore, most centers perform correction osteotomies of the cervical spine progressively, with day-by-day adjustment of the external fixators. We present a case of cervical osteotomy in which, under local anesthesia and with the aid of S.S.E.P., cervical kyphosis was corrected by a one-stage procedure. The results and difficulties are described here-in.

並列關鍵字

osteotomy ； cervical spine ； flexion deformity(kyphotic deformity)

國際替代計量

Correction Osteotomy of Flexion Deformity of Cervical Spine in Ankylosing Spondylitis - A Case Report-

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