Risk factors of hip joint structural changes following pedicle subtraction osteotomy for ankylosing spondylitis-related thoracolumbar kyphosis: a minimum two-year observation,European Spine Journal

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Risk factors of hip joint structural changes following pedicle subtraction osteotomy for ankylosing spondylitis-related thoracolumbar kyphosis: a minimum two-year observation
European Spine Journal ( IF 2.6 ) Pub Date : 2023-05-08 , DOI: 10.1007/s00586-023-07726-0
Yao Li ₁ , Bang-Ping Qian ₁ , Yong Qiu ₁ , Yang Yu ₁ , Bin Wang ₁

Affiliation

Purpose

To determine the clinical- and surgical-related factors of hip joint structural changes in ankylosing spondylitis (AS) patients with thoracolumbar kyphosis who underwent PSO.

Methods

Hip involvement was assessed by the Bath Ankylosing Spondylitis Radiology Hip Index (BASRI-h) and defined by a score of at least 2. 52 patients with BASRI-h scores maintained and 78 patients with BASRI-h scores increased during follow-up were retrospectively reviewed. Clinical data were recorded. Radiological assessment was performed preoperatively, postoperatively, and at the final follow-up.

Results

No significant difference existed in age, gender and follow-up time between the groups, but earlier onset of AS, longer disease and kyphotic duration, and worse Bath Ankylosing Spondylitis Functional Index (BASFI) scores at the final follow-up were observed in patients with BASRI-h scores increased (P < 0.05). Besides, global kyphosis (GK), T1-pelvic angle (TPA), pelvic tilt (PT) and anterior pelvic plane angle (APPA) were always larger in patients with BASRI-h scores increased, accompanied with more sacral fixation (P < 0.05). Multivariate logistics regression showed that earlier onset of AS, longer kyphotic duration, larger preoperative GK, sacral fixation and larger APPA during follow-up were independent risk factors.

Conclusion

Earlier onset of AS and longer kyphotic duration were the clinical risk factors of hip joint structural changes in AS patients following PSO, while larger preoperative GK, sacral fixation in PSO and larger APPA during follow-up were the surgical-related factors. Surgeons should inform patients with risk factors of the possibility for severe hip joint structural changes after PSO.

中文翻译：

强直性脊柱炎相关胸腰椎后凸椎弓根截骨术后髋关节结构改变的危险因素：至少两年观察

目的

旨在确定接受 PSO 的胸腰椎后凸的强直性脊柱炎 (AS) 患者髋关节结构变化的临床和手术相关因素。

方法

髋关节受累通过巴斯强直性脊柱炎放射学髋关节指数 (BASRI-h) 进行评估，并定义为至少 2 分。回顾性分析了随访期间 52 名 BASRI-h 评分维持不变的患者和 78 名 BASRI-h 评分增加的患者已审查。记录临床数据。在术前、术后和最后一次随访时进行放射学评估。

结果

各组之间年龄、性别和随访时间无显着差异，但患者 AS 发病较早，疾病和脊柱后凸持续时间较长，末次随访时巴斯强直性脊柱炎功能指数 (BASFI) 评分较差随着 BASRI-h 评分的增加（ P < 0.05）。此外，BASRI-h 评分升高的患者整体后凸 (GK)、T1-骨盆角 (TPA)、骨盆倾斜 (PT) 和骨盆前平面角 (APPA) 均较大，且伴有更多的骶骨固定（ P < 0.05））。多因素logistic回归显示AS发病较早、脊柱后凸持续时间较长、术前GK较大、骶骨固定以及随访期间APPA较大是独立危险因素。