BACKGROUND: Andersson lesion (AL) is a rare complication of ankylosing spondylitis (AS). Its clinical outcome of surgical treatment needs further exploration. OBJECTIVE: To evaluate the clinical and radiological outcomes of transforaminal thoracolumbar intervertebral fusion (TTIF) in the treatmentof AS patients with thoracolumbar AL. METHODS: Fourteen patients with thoracolumbar AL who suffered from back pain, spinal instability or kyphotic deformity were retrospectively recruited. The clinical outcomes were evaluated with Visual Analog Scale (VAS) and Oswestry Disability Index (ODI). Radiological outcomes were measured with local kyphotic (LK) angle and general kyphotic (GK) angle. RESULTS: Before surgical treatment for the AL patients, their VAS score and ODI score was 8.0 ± 0.2 and 64.0 ± 6.9, respectively. After TTIF surgery, VAS score of the patients was improved to 2.4 ± 0.5 (p< 0.01) and ODI score was decreased to 17.0 ± 3.7 (p< 0.01). One patient with neurological deficit showed an improvement in the Frankel grade from C to D and all others were grated E-level before and after surgery. For radiological outcomes, patients’ LK angle was reduced from 18.5 ± 7.2 to 11.0 ± 6.4 (p< 0.01) and GK angle was reduced to 38.6 ± 8.8 from 42.8 ± 10.4 (p< 0.01) at the 1-year follow-up. CONCLUSION: For AS patients with thoracolumbar AL, we propose that TTIF is an effective and safe operative treatment, which can achieve good fusion, satisfactory radiological and clinical outcomes.

中文翻译：

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强直性脊柱炎患者经椎间孔胸腰椎椎间融合术治疗安德森损伤的临床疗效

背景：安德森病变（AL）是强直性脊柱炎（AS）罕见的并发症。其手术治疗的临床疗效尚需进一步探索。目的：评价经椎间孔胸腰椎间融合术（TTIF）治疗AS合并胸腰椎AL的临床和影像学结果。方法：回顾性招募14例患有背痛、脊柱不稳或后凸畸形的胸腰椎AL患者。使用视觉模拟量表 (VAS) 和 Oswestry 残疾指数 (ODI) 评估临床结果。用局部后凸 (LK) 角和一般后凸 (GK) 角测量放射结果。结果：AL患者手术治疗前VAS评分和ODI评分分别为8.0±0.2和64.0±6.9。TTIF手术后，患者的VAS评分提高到2.4±0.5（p<0.01），ODI评分降低到17.0±3.7（p<0.01）。一名神经功能缺损患者的 Frankel 分级从 C 级提高到 D 级，所有其他患者在手术前后均被评为 E 级。对于放射学结果，在 1 年的随访中，患者的 LK 角从 18.5 ± 7.2 降低到 11.0 ± 6.4 (p<0.01)，GK 角从 42.8 ± 10.4 (p<0.01) 降低到 38.6 ± 8.8。结论：对于AS合并胸腰椎AL患者，我们认为TTIF是一种有效、安全的手术治疗方法，可取得良好的融合，影像学和临床疗效满意。一名神经功能缺损患者的 Frankel 分级从 C 级提高到 D 级，所有其他患者在手术前后均被评为 E 级。对于放射学结果，在 1 年的随访中，患者的 LK 角从 18.5 ± 7.2 降低到 11.0 ± 6.4 (p<0.01)，GK 角从 42.8 ± 10.4 (p<0.01) 降低到 38.6 ± 8.8。结论：对于AS合并胸腰椎AL患者，我们认为TTIF是一种有效、安全的手术治疗方法，可取得良好的融合，影像学和临床疗效满意。一名神经功能缺损患者的 Frankel 分级从 C 级提高到 D 级，所有其他患者在手术前后均被评为 E 级。对于放射学结果，在 1 年的随访中，患者的 LK 角从 18.5 ± 7.2 降低到 11.0 ± 6.4 (p<0.01)，GK 角从 42.8 ± 10.4 (p<0.01) 降低到 38.6 ± 8.8。结论：对于AS合并胸腰椎AL患者，我们认为TTIF是一种有效、安全的手术治疗方法，可取得良好的融合，影像学和临床疗效满意。