title: Results of surgical correction of kyphotic deformities of the spine in ankylosing spondylitis on the basis of the modified arthritis impact measurement scales.
abstract: METHODS
  This is a retrospective study of patient outcome in ankylosing spondylitis patients with fixed kyphotic deformities of the spine who underwent reconstructive surgery.
  
  
  OBJECTIVE
  To measure the multidimensional effects of reconstructive spinal osteotomy in this patient group with a questionnaire-based instrument.
  
  
  BACKGROUND
  Between 1979 and 1988, 175 ankylosing spondylitis patients underwent operative treatment for fixed flexion deformities of the spine. One hundred forty-eight of these patients answered the questionnaire correctly and were included in the study. The others either died or were lost to follow-up.
  
  
  METHODS
  The modified Arthritis Impact Measurement Scales with eight scales and 60 items plus six additional summative questions were administered at a mean follow-up period of 4.8 years (range, 2-10 years). The modified Arthritis Impact Measurement Scale measures eight scales--mobility, physical, household, daily, social activity, pain, anxiety, and depression. The Wilcoxon and chi-square test were used for analysis.
  
  
  RESULTS
  Forty-seven of 60 items showed significant improvement of activity levels or status. Only two items showed a significant impairment of function. Of the patients, 88.4% were very satisfied with the result of the operation; 60.9% were able to return to work. Age, sex, and type of surgical technique did not influence the results.
  
  
  CONCLUSIONS
  The modified Arthritis Impact Measurement Scales approach shows excellent overall improvement of health status after surgery, proving the worth of reconstructive surgery in ankylosing spondylitis patients with fixed kyphotic deformities of the spine.
authors.affiliation: Center of Spine Surgery, German Scoliosis Center, Werner-Wicker-Clinic, Bad Wildungen-Reinhardshausen.
authors.forename: H
authors.initials: H
authors.lastname: Halm
authors.forename: P
authors.initials: P
authors.lastname: Metz-Stavenhagen
authors.forename: K
authors.initials: K
authors.lastname: Zielke
mesh_terms: D000203:Activities of Daily Living; D001007:Anxiety / Q000601:surgery; D001168:Arthritis / Q000601:surgery*; D003863:Depression / Q000601:surgery; D006305:Health Status Indicators; D006801:Humans; D007738:Kyphosis / Q000000981:diagnostic imaging / Q000601:surgery*; D010146:Pain / Q000601:surgery; D011859:Radiography; D012189:Retrospective Studies; D012919:Social Behavior; D013167:Spondylitis, Ankylosing / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome