Abstract
Ankylosing spondylitis (AS) is a kind of chronic inflammatory disease, which usually results in spinal deformity. The feature of this deformity is a combination of severe thoracic kyphosis and flattening of the lumbar lordosis, accompanied with the head and neck thrust forward. As a consequence, patient’s truncal center of the body shifts downward and forward. To maintain the sagittal balance, the patient extensions hips, flexes knees, and plantar flexes ankles. AS patients cannot move the other spinal segment compensate. Patients in sagittal imbalance condition are hard to walk or stand erect without overwork of musculature. The compromised position leads to muscle fatigue and activity-related pain, restricts activities of daily living, and causes intra-abdominal complications [1–3]. The goal of surgical correction of these patients is to restore an optimal sagittal balance and retrieve spinal alignment and horizontal vision for obtaining satisfactory clinical results besides appearance [4–6].
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Kubiak EN, Moskovich R, Errico TJ, et al. Orthopaedic management of ankylosing spondylitis. J Am Acad Orthop Surg. 2005;13(4):267–78.
McGonagle D, Khan MA, Marzo-Ortega H, et al. Enthesitis in spondyloarthropathy. Curr Opin Rheumatol. 1999;11:244–50.
Chang KW. Quality control of reconstructed sagittal balance for sagittal imbalance. Spine. 2011;36:E186–97.
Mac-Thiong JM, Transfeldt EE, Mehbod AA, et al. Can C7 plumbline and gravity line predict health related quality of life in adult scoliosis? Spine. 2009;34:E519–27.
Glassman SD, Bridwell K, Dimar JR, et al. The impact of positive sagittal balance in adult spinal deformity. Spine. 2005;30:2024–9.
Chang KW, Chen YY, Lin CC, et al. Closing wedge osteotomy versus opening wedge osteotomy in ankylosing spondylitis with thoracolumbar kyphotic deformity. Spine (Phila Pa 1976). 2005;30:1584–93.
Smith-Peterson M, Larson C, Aufranc O. Osteotomy of the spine for correction of flexion deformity in rheumatoid arthritis. J Bone Joint Surg Am. 1945;27:1–11.
Boachie-Adjei O, Ferguson JI, Pigeon RG, et al. Transpedicular lumbar wedge resection osteotomy for fixed sagittal imbalance: surgical technique and farly results. Spine. 2006;31:485–92.
Van Royen BJ, De Gast A. Lumbar osteotomy for correction of thoracolumbar kyphotic deformity in ankylosing spondylitis: a structured review of three methods of treatment. Ann Rheum Dis. 1999;58:399–406.
Chen IH, Chien JT, Yu TC. Transpedicular wedge osteotomy for correction of thoracolumbar kyphosis in ankylosing spondylitis experience with 78 patients. Spine (Phila Pa 1976). 2001;26(16):E354–60.
Hehne H-J, Zielke K, Böhm H. Polysegmental lumbar osteotomies and transpedicled fixation for correction of long-curved kyphotic deformities in ankylosing spondylitis. Report on 177 cases. Clin Orthop. 1990;258:49–55.
Wang Y, Zhang Y, Mao K, et al. Transpedicular bivertebrae wedge osteotomy and discectomy in lumbar spine for severe ankylosing spondylitis. J Spinal Disord Tech. 2010;23:186–91.
Kiaer T, Gehrchen M. Transpedicular closed wedge osteotomy in ankylosing spondylitis: results of surgical treatment and prospective outcome analysis. Eur Spine J. 2010;19:57–64.
Van Royen BJ, De Gast A, Smit TH. Deformity planning for sagittal plane corrective osteotomies of the spine in ankylosing spondylitis. Eur Spine J. 2000;9:492–8.
von Royen BJ, Slot GM. Closing-wedge posterior osteotomy for ankylosing spondylitis. J Bone Joint Surg Br. 1995;77:117–21.
Tokala DP, Lam KS, Freeman BJ, et al. C7 decancellisation closing wedge osteotomy for the correction of fixed cervico-thoracic kyphosis. Eur Spine J. 2007;16:1471–8.
Khoueir P, Hoh DJ, Wang MY. Use of hinged rods for controlled osteoclastic correction of a fixed cervical kyphotic deformity in ankylosing spondylitis. J Neurosurg Spine. 2008;8(6):579–83.
Hoh DJ, Khoueir P, Wang MY, et al. Management of cervical deformity in ankylosing spondylitis. Neurosurg Focus. 2008;24(1):E9.
McMaster MJ. Osteotomy of the cervical spine in ankylosing spondylitis. J Bone Joint Surg Br. 1997;79(2):197–203.
Simmons EH. The surgical correction of flexion deformity of the cervical spine in ankylosing spondylitis. Clin Orthop Relat Res. 1972;86:132–43.
Mehdian SM, Freeman BJ, Licina P. Cervical osteotomy for ankylosing spondylitis: an innovative variation on an existing technique. Eur Spine J. 1999;8:505–9.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2019 Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Zheng, G., Zhang, Y., Song, D., Wang, Y. (2019). Classification and Surgical Decision-Making for Ankylosing Spondylitis Kyphosis. In: Wang, Y. (eds) Surgical Treatment of Ankylosing Spondylitis Deformity . Springer, Singapore. https://doi.org/10.1007/978-981-13-6427-3_5
Download citation
DOI: https://doi.org/10.1007/978-981-13-6427-3_5
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-13-6426-6
Online ISBN: 978-981-13-6427-3
eBook Packages: MedicineMedicine (R0)