Comparison of surgical strategies and corrective efficacy score for AS kyphotic correction
Abstract
Thoracolumbar kyphosis in ankylosing spondylitis poses multiple hazards to patients. To optimize the surgical correction of internal fixation, the biomechanical characteristics and corrective efficacy of different strategies for surgical correction of kyphosis were analyzed based on finite element analysis. The outcome revealed that there were significant deformational displacement differences and stress differences between the different orthopedic internal fixation schemes. Cortical bone track screw fixation significantly reduced the deformation displacement in flexion-extension and lateral flexion conditions. Among the proximal stresses, the cortical bone track screws had the highest stresses in the rotational condition, which could reach 446.661 MPa and 398.16 MPa. They were more resistant to pullout as the traditional all-pedicle screws. Different internal fixation protocols produced different orthopedic clinical outcomes. Patients in the experimental group of conventional all-pedicle screws versus cortical trajectory screw fixation had better Cobb angle, Oswestry incapacity index, sagittal equilibrium distance, and Scoliosis Research Society-22 patient questionnaire scores. This study may provide optimized recommendations for the development of surgical corrective internal fixation protocols and guide the development of surgical strategies, which in turn may promote patient recovery and reduce complications.
References
1. Khan MA. HLA-B*27 and Ankylosing Spondylitis: 50 Years of Insights and Discoveries. Current Rheumatology Reports. 2023; 25(12): 327-340. doi: 10.1007/s11926-023-01118-5
2. Britanova OV, Lupyr KR, Staroverov DB, et al. Targeted depletion of TRBV9+ T cells as immunotherapy in a patient with ankylosing spondylitis. Nature Medicine. 2023; 29(11): 2731-2736. doi: 10.1038/s41591-023-02613-z
3. Burmester GR, Cohen SB, Winthrop KL, et al. Safety profile of upadacitinib over 15 000 patient-years across rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and atopic dermatitis. RMD Open. 2023; 9(1): e002735. doi: 10.1136/rmdopen-2022-002735
4. Tas NP, Kaya O, Macin G, et al. ASNET: A Novel AI Framework for Accurate Ankylosing Spondylitis Diagnosis from MRI. Biomedicines. 2023; 11(9): 2441. doi: 10.3390/biomedicines11092441
5. McGonagle D, David P, Macleod T, et al. Predominant ligament-centric soft-tissue involvement differentiates axial psoriatic arthritis from ankylosing spondylitis. Nature Reviews Rheumatology. 2023; 19(12): 818-827. doi: 10.1038/s41584-023-01038-9
6. Yu H, Wang Q, Fan Y, et al. Vertebral Column Decancellation for Correcting Cervicothoracic Kyphotic Deformity in Patients with Ankylosing Spondylitis. Orthopaedic Surgery; 2024. doi: 10.1111/os.14306
7. Li W, Tong G, Cai B, et al. Analysis of the outcome of bi-vertebral transpedicular wedge osteotomy for correcting severe kyphotic deformity in ankylosing spondylitis. Medicine. 2023; 102(26): e34155. doi: 10.1097/md.0000000000034155
8. Hu Z, Zhong R, Zhao D, et al. Staged osteotomy in lateral position for the treatment of severe kyphotic deformity secondary to ankylosing spondylitis: a retrospective study. Journal of Orthopaedic Surgery and Research. 2023; 18(1). doi: 10.1186/s13018-023-03884-5
9. Ding Z, Wang Y, Kang N, et al. A posterior trans-intervertebral osteotomy with anterior support for kyphosis deformity secondary to ankylosing spondylitis: a technical note. BMC Musculoskeletal Disorders. 2025; 26(1). doi: 10.1186/s12891-024-08260-w
10. Zhang Z, Wang T, Xue C, et al. Comparing outcomes for single-segment vertebral column decancellation performed at different vertebras in ankylosing spondylitis-an observational study. BMC Musculoskeletal Disorders. 2024; 25(1). doi: 10.1186/s12891-024-07998-7
11. Luo J, Wu T, Yang Z, et al. An effective strategy for treatment of severe kyphosis secondary to ankylosing spondylitis: one-level modified osteotomy combined with shoulders lifting correction method. Journal of Orthopaedic Surgery and Research. 2024; 19(1). doi: 10.1186/s13018-024-05005-2
12. Lv X, Nuertai Y, Wang Q, et al. Multilevel Pedicle Subtraction Osteotomy for Correction of Thoracolumbar Kyphosis in Ankylosing Spondylitis: Clinical Effect and Biomechanical Evaluation. Neurospine. 2024; 21(1): 231-243. doi: 10.14245/ns.2347118.559
13. Li X, Kim YC, Kim SM, et al. Determining the vertebra for pedicle subtraction osteotomy in surgical correction for ankylosing spondylitis with thoracolumbar kyphosis. Journal of Neurosurgery: Spine. 2024; 41(3): 325-331. doi: 10.3171/2024.4.spine231218
14. Qiao M, Qian B ping, Qiu Y, et al. Coronal deformity in ankylosing spondylitis with concomitant thoracolumbar kyphosis: patterns, manifestations and surgical strategies. European Spine Journal. 2024; 33(8): 2935-2951. doi: 10.1007/s00586-024-08357-9
15. Yin W, Zheng G, Zhang W, et al. A new mathematical model for evaluating surface changes in the mid-abdominal sagittal plane after two-level pedicle reduction osteotomy in patients with ankylosing spondylitis. BMC Surgery. 2024; 24(1). doi: 10.1186/s12893-023-02285-z
16. Kocyigit BF, Sagtaganov Z, Yessirkepov M, et al. Assessment of complementary and alternative medicine methods in the management of ankylosing spondylitis, rheumatoid arthritis, and fibromyalgia syndrome. Rheumatology International. 2022; 43(4): 617-625. doi: 10.1007/s00296-022-05267-1
17. Markov M, Georgiev T, Angelov AK, et al. Adhesion molecules and atherosclerosis in ankylosing spondylitis: implications for cardiovascular risk. Rheumatology International. 2024; 44(10): 1837-1848. doi: 10.1007/s00296-024-05693-3
18. Boudjani R, Challal S, Semerano L, et al. Impact of different types of exercise programs on ankylosing spondylitis: a systematic review and meta-analysis. Disability and Rehabilitation. 2022; 45(24): 3989-4000. doi: 10.1080/09638288.2022.2140842
19. Hallström M, Klingberg E, Deminger A, et al. Physical function and sex differences in radiographic axial spondyloarthritis: a cross-sectional analysis on Bath Ankylosing Spondylitis Functional Index. Arthritis Research & Therapy. 2023; 25(1). doi: 10.1186/s13075-023-03173-w
20. Liao HT, Tsai CY. Cytokines and regulatory T cells in ankylosing spondylitis. Bone & Joint Research. 2023; 12(2): 133-137. doi: 10.1302/2046-3758.122.bjr-2022-0195.r1
21. Yan F, Wu L, Lang J, et al. Bone density and fracture risk factors in ankylosing spondylitis: a meta-analysis. Osteoporosis International. 2023; 35(1): 25-40. doi: 10.1007/s00198-023-06925-1
22. Hu W, Yang G, Shi X, et al. Effects of pedicle subtraction osteotomy on aortic morphology and hemodynamics in ankylosing spondylitis with kyphosis: a finite element analysis study. Scientific Reports. 2024; 14(1). doi: 10.1038/s41598-024-77417-3
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