Application Of Serial Digital Orthopedics In The Treatment Of Ankylosing Spondylitis Kyphosis Deformity

Objectives:Evaluation of the safety and effectiveness of a series of digital orthopedic techniques for spinal osteotomy.Methods:A total of 14 patients with ankylosing spondylitis kyphosis and osteotomy were enrolled from January 2016 to September 2018 in Zhengzhou University Affiliated People’s Hospital(Henan Provincial People’s Hospital).All patients were performed ankylosing spondylitis kyphoplasty after complete examination and exclusion of surgical contraindications.The Oswestry Disability Index(ODI),Chin brow vertical angle(CBVA),Thoracic and lumbar kyphosis Cobb’s angle,Sagittal vertical axis(SVA),Pelvic tilt(PT),Pelvic incidence(PI),Sacral slope(SS)were collected before and after operation.For obtaining the accuracy of osteotomy,we conducted two comparisons:(1)the width of posterior margin osteotomy space recorded during operation and the height of posterior margin osteotomy designed before operation,(2)the Cobb angle of thoracolumbar kyphosis in DR upper thoracolumbar spine and the preoperative angle after operation.The related complications were observed and the collected data were analyzed by SPSS22.0 software.Results:All patients completed the operation successfully.The operation time was(355.2+77.9)min,the amount of bleeding during the operation was(1327.0 +634.0)ml.One patient had cerebrospinal fluid leakage after operation,which improved after symptomatic treatment.One patient had more than 50% change of MEP signal during operation.After hormone treatment,the MEP signal returned to normal,and no new neurological impairment occurred after operation.No serious complications occurred in the remaining patients.All patients were followed up for(13.8 +9.7)months,and the wounds healed well after operation.The Oswestry Disability Index(ODI)was31.6(+6.3)before operation,13.3(+5.1)at 2 weeks after operation and 7.2(+4.4)at the last follow-up.There were significant differences in ODI between 2 weeks after operation and at the last follow-up(P<0.05).There were significant differences in mandibular and eyebrow angle,thoracolumbar kyphosis Cobb angle,SVA,PT and SS between the two weeks after operation and the last follow-up(P < 0.05).Moreover,there was no significant difference in PI between pre-operation and post-operation(P > 0.05).Postoperative horizon and self-care ability were significantly improved.At the last follow-up,no loosening,displacement or fracture of the internal fixation was found,and all the bone grafts were bone fusion.Conclusion:Digital technology assisted precise osteotomy for kyphosis deformity of ankylosing spondylitis is feasible and effective.