Spinal Osteotomy in Patients With Ankylosing Spondylitis: Complications During First Postoperative Year.

摘要

STUDY DESIGN.: A historic cohort to determine short-term complications after 115 corrective osteotomies of the cervical and lumbar spine in patients with ankylosing spondylitis. OBJECTIVES.: To describe the nature of complications of spinal osteotomies and sequelae. SUMMARY OF BACKGROUND DATA.: Little is known about the rate and nature of complications after spinal osteotomy in these patients. METHODS.: A chart review of 106 patients (age, 21-82 years) was conducted. The following surgical techniques were performed: cervical-thoracic extending osteotomy at C6-Th1 (n = 22), lumbar closing-wedge osteotomy (n = 62), polysegmental lumbar osteotomy (n = 20), or a combined anterior-posterior lumbar correction (n = 11). RESULTS.: Many complications (7.8% permanent neurologic deficit, 9.6% deep wound infections, and 10.4% major general complications) occurred after performing a spinal correction. Since 1998, there is a tendency for a lower rate of infections but a higher rate of neurologic and major general complications. Because of 27% deep wound infections and 18% major general complications, the technique of combined anterior and posterior surgery has been abandoned. CONCLUSION.: High complication rates in this group of patients are partly due to the difficult surgery but also to the underlying disease. The surgery should be concentrated in specialized centers.