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Systemic changes associated with quality of life after surgical treatment of kyphotic deformity in patients with ankylosing spondylitis: a systematic review

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Abstract

Purpose

In addition to changes in the skeletal system after spinal osteotomy for treatment of kyphotic deformity in advanced-stage AS patients, many other systemic changes associated with the patients’ quality of life were reported. The purpose of this study was to conduct a systemic review of the literature to determine systemic changes associated with patients’ quality of life following correction of kyphotic deformity secondary to ankylosing spondylitis.

Methods

We searched the databases PubMed, EMBASE, Clinicalkey and Cochrane Library without time restriction. Selected papers were assessed by published guidelines. We investigated systemic changes associated with patients’ quality of life after surgical treatment of advanced ankylosing spondylitis.

Results

The initial search yielded 888 citations. Twelve of these studies met the inclusion and exclusion criteria. Two were level II evidence study, and ten were level III evidence studies. Changes were reported including aorta length, abdominal morphology, digestive function, cardiopulmonary function, psychological status, and sexual activity.

Conclusions

In addition to skeletal changes after spinal osteotomy for treatment of kyphotic deformity in advanced-stage AS patients, many other changes were reported. Spine surgeons should pay more attention to these life quality-related changes and be aware of potential risks when performing surgery for advanced-stage AS patients.

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References

  1. Zhong W (2019) Two-level osteotomy for the corrective surgery of severe kyphosis from ankylosing spondylitis: a retrospective series. Spine (Phila Pa 1976) 44(23):1638–1646

    Article  Google Scholar 

  2. Zhu W (2019) Ankylosing spondylitis: etiology, pathogenesis, and treatments. Bone Res 7:22

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Liu ZJ (2019) Does relocation of the apex after osteotomy affect surgical and clinical outcomes in patients with ankylosing spondylitis and thoracolumbar kyphosis? J Neurosurg Spine 2019:1–8

    Article  Google Scholar 

  4. Britto NMF, Renor BS, Ghizoni E, Tedeschi H, Joaquim AF (1992) Spine surgery in patients with ankylosing spondylitis. Rev Assoc Med Bras 64(4):379–383

    Article  Google Scholar 

  5. Luksanapruksa P (2019) Comparison of surgical outcomes of the posterior and combined approaches for repair of cervical fractures in ankylosing spondylitis. Asian Spine J 13(3):432–440

    Article  PubMed  PubMed Central  Google Scholar 

  6. Wang T (2019) Staged cervical osteotomy: a new strategy for correcting ankylosing spondylitis thoracolumbar kyphotic deformity with fused cervical spine. J Orthop Surg Res 14(1):108

    Article  PubMed  PubMed Central  Google Scholar 

  7. Yildiz F, Akgül T, Ekinci M, Dikici F, Şar C, Domaniç Ü (2017) Results of closing wedge osteotomy in the treatment of sagittal imbalance due to ankylosing spondylitis. Acta Orthop Traumatol Turc 50(1):63–68

    Google Scholar 

  8. Liang Y (2017) Posterior wedge osteotomy and debridement for Andersson lesion with severe kyphosis in ankylosing spondylitis. J Orthop Surg Res 12(1):54

    Article  PubMed  PubMed Central  Google Scholar 

  9. Wright JG, Swiontkowski MF, Heckman JD (2003) Introducing levels of evidence to the journal. J Bone Jt Surg [Am] 85-A:1–3

    Article  Google Scholar 

  10. Wells G, Shea B, O’Connell D et al (2009) The Newcastle–Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses. http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp. Accessed 19 Oct 2009

  11. Liu H (2017) Does the traversing length of the aorta change after closing wedge osteotomy for ankylosing spondylitis patients with thoracolumbar kyphosis?: A magnetic resonance imaging investigation. Spine (Phila Pa 1976) 42(2):106–112

    Article  Google Scholar 

  12. Liu C (2017) The safe correction angle of osteotomy at T12 and L1 for ankylosing spondylitis kyphosis: patients with 2-level osteotomy. Clin Spine Surg 30(7):E942–E947

    Article  PubMed  Google Scholar 

  13. Ji ML (2013) Change of aortic length after closing-opening wedge osteotomy for patients with ankylosing spondylitis with thoracolumbar kyphosis: a computed tomographic study. Spine (Phila Pa 1976) 38(22):E1361–E1367

    Article  Google Scholar 

  14. Liu C (2015) Changes of the abdomen in patients with ankylosing spondylitis kyphosis. Spine (Phila Pa 1976) 40(1):E43–E48

    Article  Google Scholar 

  15. Liu C (2015) The radiologic, clinical results and digestive function improvement in patients with ankylosing spondylitis kyphosis after pedicle subtraction osteotomy. Spine J 15(9):1988–1993

    Article  PubMed  Google Scholar 

  16. Ji ML (2015) Change in abdominal morphology after surgical correction of thoracolumbar kyphosis secondary to ankylosing spondylitis: a computed tomographic study. Spine (Phila Pa 1976) 40(23):E1244–E1249

    Article  Google Scholar 

  17. Fu J (2014) Pulmonary function improvement in patients with ankylosing spondylitis kyphosis after pedicle subtraction osteotomy. Spine (Phila Pa 1976) 39(18):E1116–E1122

    Article  Google Scholar 

  18. Zhang G (2015) Lung volume change after pedicle subtraction osteotomy in patients with ankylosing spondylitis with thoracolumbar kyphosis. Spine (Phila Pa 1976) 40(4):233–237

    Article  CAS  Google Scholar 

  19. Liu C (2019) Correlation between diaphragmatic sagittal rotation and pulmonary dysfunction in patients with ankylosing spondylitis accompanied by kyphosis. J Int Med Res 47(5):1877–1883

    Article  PubMed  PubMed Central  Google Scholar 

  20. Fu J, Song K, Zhang YG, Zheng GQ, Zhang GY, Liu C, Wang Y (2015) Changes in cardiac function after pedicle subtraction osteotomy in patients with a kyphosis due to ankylosing spondylitis. Bone Jt J 97-b(10):1405–1410

    Article  CAS  Google Scholar 

  21. Park JS (2019) Psychological changes and employment outcomes after kyphosis correction in patients with ankylosing spondylitis. Spine (Phila Pa 1976) 44(14):996–1002

    Article  Google Scholar 

  22. Park YS, Kim HS (2014) Spinal osteotomy in ankylosing spondylitis: radiological, clinical, and psychological results. Spine J 14(9):1921–1927

    Article  PubMed  Google Scholar 

  23. Yao Z (2016) Changes in sexual activity in male patients surgically treated for kyphosis due to ankylosing spondylitis. Spine (Phila Pa 1976) 41(17):1340–1345

    Article  Google Scholar 

  24. Smith-Petersen MN, Larson CB, Aufranc OE (1945) Osteotomy of the spine for correction of flexion deformity in rheumatoid arthritis. J Bone Jt Surg Am 27:1–11

    Google Scholar 

  25. Zhang X (2016) Treatment of Andersson lesion-complicating ankylosing spondylitis via transpedicular subtraction and disc resection osteotomy, a retrospective study. Eur Spine J 25(8):2587–2595

    Article  PubMed  Google Scholar 

  26. Wang Y (2010) Transpedicular bivertebrae wedge osteotomy and discectomy in lumbar spine for severe ankylosing spondylitis. J Spinal Disord Tech 23(3):186–191

    Article  PubMed  Google Scholar 

  27. Kim KT (2013) Partial pedicle subtraction osteotomy as an alternative option for spinal sagittal deformity correction. Spine (Phila Pa 1976) 38(14):1238–1243

    Article  Google Scholar 

  28. Hu W (2016) Y shape osteotomy in ankylosing spondylitis, a prospective case series with minimum 2 year follow-up. PLoS One 11(12):e0167792

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Kim KT (2015) Results of corrective osteotomy and treatment strategy for ankylosing spondylitis with kyphotic deformity. Clin Orthop Surg 7(3):330–336

    Article  PubMed  PubMed Central  Google Scholar 

  30. Qian BP, Wang XH, Qiu Y et al (2012) The influence of closing–opening wedge osteotomy on sagittal balance in thoracolumbar kyphosis secondary to ankylosing spondylitis: a comparison with closing wedge osteotomy. Spine (Phila Pa 1976) 37(16):1415–1423

    Article  Google Scholar 

  31. Zhang X, Zhang Z, Wang J, Lu M, Hu W, Wang Y, Wang Y (2016) Vertebral column decancellation: a new spinal osteotomy technique for correcting rigid thoracolumbar kyphosis in patients with ankylosing spondylitis. Bone Jt J 98-b(5):672–678

    Article  CAS  Google Scholar 

  32. Zhang HQ (2014) Two-level pedicle subtraction osteotomy for severe thoracolumbar kyphotic deformity in ankylosing spondylitis. Eur Spine J 23(1):234–241

    Article  PubMed  Google Scholar 

  33. Hua WB (2017) Analysis of sagittal parameters in patients undergoing one- or two-level closing wedge osteotomy for correcting thoracolumbar kyphosis secondary to ankylosing spondylitis. Spine (Phila Pa 1976) 42(14):E848–E854

    Article  Google Scholar 

  34. Qu Z (2016) Does the position of the aorta change with the altered body position in ankylosing spondylitis patients with thoracolumbar kyphosis?-A magnetic resonance imaging investigation. Clin Spine Surg 30(7):328–334

    Article  Google Scholar 

  35. Feng F (2013) Position of the aorta relative to the spine in patients with thoracolumbar/lumbar kyphosis secondary to ankylosing spondylitis. Spine (Phila Pa 1976) 38(20):E1235–E1241

    Article  Google Scholar 

  36. Chang KW, Cheng CW, Chen HC, Chang KI, Chen TC (2008) Closing-opening wedge osteotomy for the treatment of sagittal imbalance. Spine (Phila Pa 1976) 33(13):1470–1477

    Article  Google Scholar 

  37. Kiaer T (2010) Transpedicular closed wedge osteotomy in ankylosing spondylitis: results of surgical treatment and prospective outcome analysis. Eur Spine J 19(1):57–64

    Article  PubMed  Google Scholar 

  38. Kanathur N (2010) Pulmonary manifestations of ankylosing spondylitis. Clin Chest Med 31(3):547–554

    Article  PubMed  Google Scholar 

  39. Brambila-Tapia AJ (2013) Pulmonary function in ankylosing spondylitis: association with clinical variables. Rheumatol Int 33(9):2351–2358

    Article  CAS  PubMed  Google Scholar 

  40. Berdal G (2012) Restrictive pulmonary function is more prevalent in patients with ankylosing spondylitis than in matched population controls and is associated with impaired spinal mobility: a comparative study. Arthritis Res Ther 14(1):R19

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  41. Hsieh LF (2014) Combined home exercise is more effective than range-of-motion home exercise in patients with ankylosing spondylitis: a randomized controlled trial. Biomed Res Int 2014:398190

    PubMed  PubMed Central  Google Scholar 

  42. Akyol G, Ozalevli S, Ucan ES (2013) The relationship between pulmonary function and exercise capacity and quality of life in patients with ankylosing spondylitis. Tuberk Toraks 61(3):227–234

    Article  PubMed  Google Scholar 

  43. Aydemir K (2010) The effects of balneotherapy on disease activity, functional status, pulmonary function and quality of life in patients with ankylosing spondylitis. Acta Reumatol Port 35(5):441–446

    PubMed  Google Scholar 

  44. Momeni M, Taylor N, Tehrani M (2011) Cardiopulmonary manifestations of ankylosing spondylitis. Int J Rheumatol 2011:728471

    Article  PubMed  PubMed Central  Google Scholar 

  45. Martindale J, Smith J, Sutton CJ (2006) Disease and psychological status in ankylosing spondylitis. Rheumatol (Oxf) 45:1288–1293

    Article  CAS  Google Scholar 

  46. Zhao Y (2015) Comparison of two surgeries in treatment of severe kyphotic deformity caused by ankylosing spondylitis: transpedicular bivertebrae wedge osteotomy versus one-stage interrupted two-level transpedicular wedge osteotomy. Clin Neurol Neurosurg 139:252–257

    Article  PubMed  Google Scholar 

  47. Fan D, Liu L, Ding N (2015) Male sexual dysfunction and ankylosing spondylitis: a systematic review and metaanalysis. J Rheumatol 42:252–257

    Article  PubMed  Google Scholar 

  48. Cakar E, Dincer U, Kiralp MZ (2007) Sexual problems in male ankylosing spondylitis patients: relationship with functionality, disease activity, quality of life, and emotional status. Clin Rheumatol 26:1607–1613

    Article  PubMed  Google Scholar 

  49. Ozkorumak E, Karkucak M, Civil F (2011) Sexual function in male patients with ankylosing spondylitis. Int J Impot Res 23:262–267

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Orthopedics, Beijing Chao-Yang Hospital, Capital Medical University, GongTiNanLu 8#, Chao-Yang District, Beijing, 100020, China

    Jingwei Liu, Nan Kang, Yiqi Zhang & Yong Hai

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  1. Jingwei Liu
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  2. Nan Kang
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Liu, J., Kang, N., Zhang, Y. et al. Systemic changes associated with quality of life after surgical treatment of kyphotic deformity in patients with ankylosing spondylitis: a systematic review. Eur Spine J 29, 794–802 (2020). https://doi.org/10.1007/s00586-020-06322-w

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  • DOI: https://doi.org/10.1007/s00586-020-06322-w

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