Clinical Application of Percutaneous Cement Augmentation in Ankylosing Spondylitis Patients with Junctional Vertebral Stress Fractures and Pseudarthrosis

LIU Xiaoxi

doi:10.3969/j.issn.1004-437X.2026.13.010

Abstract：Objective To investigate the feasibility of percutaneous cement augmentation for treating adjacent vertebral stress fractures with pseudarthrosis in ankylosing spondylitis(AS).Methods The study selected patients with AS complicated by adjacent vertebral stress fractures and intervertebral pseudarthrosis,who were admitted to Zhengzhou Orthopedic Hospital from January 2015 to January 2021 and met the inclusion and exclusion criteria,as the research subjects.Among them,26 patients who received percutaneous bone cement fusion surgery were assigned to the experimental group,while 25 patients who received conservative treatment during the same period were assigned to the control group.Data recorded for all patients included age,gender,operative time,amount of polymethyl methacrylate(PMMA)bone cement injected,surgical complications,and hospital stay.Visual analog scale(VAS)pain scores and Oswestry disability index(ODI)scores were recorded preoperatively,at 1 day postoperatively,at 3 months postoperatively,and at the final follow-up.Therapeutic outcomes were assessed according to the MacNab criteria.Results All surgeries in the experimental group were successfully completed.The operative time was(54.81±14.52)min,the PMMA injection volume was(13.58±1.45)mL,and the hospital stay was(6.46±1.33)days.All patients exhibited good intervertebral bone cement fusion postoperatively,with no pseudarthrosis occurrence.According to the MacNab criteria,the excellent and good rate in the experimental group was higher than that in the control group(P＜0.05).VAS and ODI scores at 1 day postoperatively,3 months postoperatively,and the final follow-up were lower than preoperative scores in all patients(P＜0.05).At postoperative follow-ups,the VAS scores of patients in the experimental group were lower than those in the control group(P＜0.05),while the ODI scores were higher than those in the control group(P＜0.05).No related complications occurred postoperatively.Conclusion Percutaneous bone cement fusion can improve the functional status of AS patients with adjacent vertebral stress fractures and pseudarthrosis,providing lasting pain relief.It is an effective option for patients unsuitable for open surgical fixation and conservative treatment.