The Effect Of Spine-pelvic Parameters Of Kyphosis Correction For Ankylosing Spondylitis By Hilus Pulmonis Approach

Objective:Through comparing the preoperative and postoperative radiographic parameters and the quality of life scores of AS kyphosis patients,the efficacy of application of Hilus pulmonis in guiding of kyphosis correction and the effect of spine-pelvic parameters were explored.Also,the impact of spine-pelvic parameters to the quality of life of patients was also explored to provide more reference for the design of osteotomy surgery.Methods:A retrospective analysis was performed during the period from January 2014 to December 2017 in the department of Orthopaedics,the First Affiliated Hospital of Jinan University.Patients who were diagnosed as ankylosing spondylitis with kyphosis and using the hilus pulmonis to guide kyphosis correction as treatment were enrolled into the study.A total of 16 cases,15 males and 1 female,were enrolled.Patients' clinical data were recorded in follow-up data.According to the X-ray of full-length spine before and 12 months after surgery,the relevant spine-pelvic imaging parameters were then measured.The SRS-22 score,ODI dysfunction score,resting heart rate,Active capacity score(ACS),and Quality of life questionnaire for functional Digestive disorders(FDDQL)score were recorded before and 12 months after orthopedics.Result:1.The postoperative spine-pelvic parameters PT,SS,GK,TLK,LL,SVA and TPA were all improved compared with preoperative parameters(P<0.05).there is a significant difference between The postoperative and 12 months post-operative TPA.2.SRS-22 score,ODI score,resting heart rate,and ACS score were significantly improved after osteotomy(P<0.05).3.Preoperative PT was positively correlated with ODI walking score(r=0.55,P=0.03),ODI standing score(r=0.83,P=0.00),and ODI total score(r=0.83,P=0.00)respectively.Preoperative GK was positively correlated with ODI walking scores(r=0.54,P=0.03),ODI standing scores(r=0.54,P=0.03),and ODI total scores(r=0.65,P=0.01)respectively.Preoperative SVA was positively correlated with ODI walking score(r=0.79,P=0.00),ODI standing score(r=0.77,P=0.00),and ODI total score(r=0.51,P=0.04)respectively.Postoperative PT was positively correlated with ODI score walking items(r=0.53,P=0.03)and standing items(r=0.60,P=0.01)respectively.Preoperative TPA was positively correlated with ODI walking score(r=0.68,P=0.00),ODI standing score(r=0.80,P=0.00)and ODI total score(r=0.51,P=0.04)respectively.4.Preoperative PT was negatively correlated with SRS-22 scoring function items(r=-0.64,P=0.00)and mental health items(r=-0.66,P=0.01)respectively.There was a negative correlation between preoperative GK and SRS-22 self-image score(r=-0.68,P=0.00).Preoperative SVA was negatively correlated with SRS-22 score functional items(r=-0.75,P=0.00),self-image items(r=-0.61,P=0.01),and mental health items(r=-0.75,P=0.00)respectively.Preoperative TPA was negatively correlated with SRS-22 scoring function items(r=-0.63,P=0.01),self-image items(r=-0.52,P=0.04)and mental health items(r=-0.55,P=0.03)respectively.Conclusions:1.After using the Hilus pulmonis to guide kyphosis correction,patients with AS kyphosis can obtain good radiographic parameters and Physical activity ability score,and can meet the functions of head-up,standing,sitting and lying in patients after orthopedic surgery.2.PT ?SVA?GK and TPA have significant influences on the quality of life of patients with AS kyphosis.Correcting spine-pelvic imaging parameters is important guarantees for higher quality of life after surgery.