Changes of activities and qualities of life related to hip joints after spinal correction of thoracolumbar kyphosis in ankylosing spondylitis

English Keywords:Ankylosing spondylitis  Kyphosis  Total hip replacement  Deformity planning

English Abstract:

  【Abstract】 Objectives: To investigate clinical effects of spinal osteotomy for ankylosing spondylitis(AS) thoracolumbar kyphosis with hip involvement. Methods: 37 AS thoracolumbar kyphotic patients were studied and were divided into 2 groups according to hip involvement[group A, patients without hip pain and range of flexion-extension motion ≥120°; group B, patients with hip pain or range of flexion-extension motion <120° or with total hip replacement(THR)]. Moreover, patients with hip involvement were divided into 3 groups(group B1, patients with no need for THR; group B2, patients with spinal correction before THR; group B3, patients with THR before spinal correction). Chief complaint at post-operation of each patient and whether it leaded to poor life were studied; SRS-22, BASFI and Harris were used to assess the quality of life of patients at pre- and post-operation. Results: Pre-operative SRS-22 function, average BASFI, and Harris function values in group A were 2.8±0.7, 3.8±1.4 and 40.8±4.7 respectively, and the post-operative values were 4.1±0.6, 2.1±1.3 and 43.6±2.6 respectively. Pre-operative values in group B were 2.4±0.6, 6±1.5 and 30.7±8.1 respectively, and the post-operative values were 3.5±0.6, 4.5±1.1 and 37.2±4.2 respectively. Both group A and group B had better activities after spinal surgery to some degrees, especially activities such as standing and walking, though some other activities(squating, putting on socks et al) became worse. Group A had better activities than group B at pre- and post-operation. Clinical results associated with hip activities were not as good as expected in group B1; patients in group B2 had poor activities after spinal correction, but good results were obtained after subsequent THR; patients in group B3 with THR firstly had improved activities after the surgery, and better results were abtained after subsequent spinal correction. However, some patients in group B3 had difficulty to sit. Conclusions: Spinal correction changes the useful range of hip flexion-extension motion in AS thoracolumbar kyphotic patients. It is significant for both spinal correction and THR.