Clinical observation of one-stage posterior debridement, interbody bone graft and internal fixation for Andersson lesion in ankylosing spondylitis

LI Wei-wei; GONG Li-qun; LIU Jun; WEI Wen-bo; DUAN Da-peng; DUAN Liang

doi:10.3969/j.issn.2095-252X.2017.07.015

Abstract：Objective To investigate the clinical results of one-stage posterior debridement, interbody bone graft and internal fixation for Andersson lesion in the patients with ankylosing spondylitis ( AS ). Methods The clinical data of 9 cases of AS complicated with Andersson lesion who underwent one-stage posterior debridement, interbody bone graft and internal fixation from January 2008 to July 2014 were retrospectively analyzed. They were all males, whose mean age was ( 52.6 ± 7.5 ) years ( range: 39 - 67 years ). As to the lesion segment, there was 1 case of T10-11, 7 cases of T11-12 and 1 case of T12 - L1. As to the preoperative Frankel grade, there were 6 cases of Grade C and 3 cases of Grade D. The operation time, blood loss, preoperative and postoperative visual analogue scale ( VAS ) scores, Frankel grade and Cobb's angle improvement of the lesion segment were measured to evaluate the therapeutic effects. Results All the patients were followed up for an average period of ( 32.8 ± 8.75 ) months ( range:24 - 56 months ). The mean operative time was ( 133.9 ± 25.3 ) min ( range: 105 - 175 min ), and the average blood loss was ( 596.7 ± 146.3 ) ml ( range: 450 - 850 ml ). The mean VAS score at 3 months after the operation was ( 2.80 ± 0.43 ), which was obviously lower than ( 8.53 ± 1.11 ) before the operation, and the differences were statistically significant ( P < 0.05 ). The mean VAS score at 24 months after the operation was ( 1.60 ± 0.45 ), which was obviously lower than that at 3 months after the operation, and the differences were statistically significant ( P < 0.05 ). The Frankel grade distribution at 24 months after the operation: 2 cases of grade D and 7 cases of grade E. The mean Cobb's angle at 3 months after the operation was ( 15.2 ± 3.73 ) °, which was lower than ( 28.3 ± 5.93 ) ° before the operation, and the differences were statistically significant ( P < 0.05 ). The mean Cobb's angle at 24 months after the operation maintained at the level of ( 15.6 ± 4.09 ) ° ( P > 0.05 ). All the cases acquired bone fusion, and the mean fusion time was 8.6 months ( range: 6 - 13 months ). Conclusions One-stage posterior debridement, interbody bone graft and internal fixation can effectively remove the lesion, restore normal spinal alignment and significantly improve neurological functions for the AS patients complicated with Andersson lesion.