Corrective osteotomy of the spine in ankylosing spondylitis. Experience with 66 cases

Abstract

Of 66 cases of corrective lumbar osteotomy for ankylosing spondylitis, 59 were men and seven were women with a follow-up period of two to 30 years after surgery. Their ages ranged from 19 to 55 years. The deformity was corrected by a one-stage posterior osteotomy and decompression of the posterior elements of the spine. Postoperative ileus, nausea, vomiting, and urinary retention were the most common surgical complications. There were no cases of permanent neurological deficit. The one fatality occurred on the ninth postoperative day because of a ruptured aorta. The results were gratifying in the 65 remaining cases. These patients were pleased with the cosmetic results, improved gait, and ability to look straight ahead. In addition to the expanded field of vision, there was general improvement in the cardiorespiratory and gastrointestinal functions plus a better mental attitude. Patients over 55 years of age, patients with aortic calcification, poor medical risks, and patients with ankylosed hips (untreated with total hip arthroplasties) are contraindications for this operation.