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Rehabilitation Practice and Science

Translated Title

脊椎內裝具於僵直性脊椎炎椎骨骨折後的脊椎固定：病例報告

Abstract

The subject patient was a case of ankylosing spondylitis (AS). Because of recurrent fine vertebral fracture combined with pseudoarthrosis and neurological deficiency, the patient had received several conventional surgical interventions over ten years. A year before the present admission, the patient suffered lower limbs weakness and received surgical intervention with thoracic corpectomy and fixation with vertebral prosthesis, anterior spinal instrumentation and posterior fusion with pedicle screw at Stanford hospital in the U.S.A. The patient tolerated the procedure well and achieved some improvement in his leg sensation and muscle power. The patient then returned to Taiwan for rehabilitation therapy at Chang-Gung memorial hospital. AS involves bone mass loss and ankylosing characteristics of the spine which result in sequential spinal deformity and even fracture lesions in late stages. The fracture lesions of ankylosed spine were harder to fix than the usual because of the tendency of AS toward interbody fusion, leading lever power to focus on the lesion site and display pseudoarthrosis formation. The traditional fixation technique for vertebral fracture in AS mainly involves a posterior instrument with interbody fusion. However, the main materials used in interbody fusion were autograft. In final surgery for this patient, titanium mesh cage was used as vertebral prosthesis for interbody fusion. From literatures review, this kind of surgery was rare in fixation of vertebral fracture in AS. The study reviewed and summarized spine change in the course of AS and the indications and contraindications of vertebral prosthesis usage in ankylosing spine. To improve spinal stability and achieve earlier rehabilitation intervention to minimize complications from immobilization, this work suggests such surgery as fixation with titanium mesh cage for patients with ankylosed spine with vertebral fracture or spondylodiscitis.

Language

Traditional Chinese

First Page

245

Last Page

252

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