[Surgical treatment of kyphotic spinal deformities in ankylosing spondylitis using the Harrington compression system: long-term results based on the MOPO scales in the framework of a retrospective questionnaire].
BACKGROUND
Meanwhile a lot of papers have been published concerning the operative treatment of kyphotic deformities of the spine in ankylosing spondylitis. Long term results from the patient's view-point on the basis of standardized parameters are not available. This was the intention of this study.


METHODS
From 1979 to 1982 34 patients underwent surgical correction of a flexion deformity of the spine in ankylosing spondylitis. Correction was achieved with four v-shaped lumbar osteotomies using Harrington's compression system. Seven to ten years postoperatively the patients were asked to answer a questionnaire containing the Mopo-scales and a few additional questions in order to compare the patients pre- and postoperative status and evaluate the long-term quality of the operative procedure. The Mopo-scales exist of the 8 subscales mobility, physical-, daily-, household-, social activity, pain, depression, anxiety with 60 questions (items). The statistical analysis was carried out with the Wilcoxon- and Chi-Square-test using a level of significance of p < 0.01.


RESULTS
Within all Mopo-subscales most items (n = 47) demonstrated significant improvement of function (p < 0.01). Whereas 11 times no significant changes could be proved, twice a significant impairment was noticed. The latter mentioned 13 items tested activities that would have been performed better in inclination, so that the results do not amaze. Visual analog scales for pain and general health status indicated significant improvement of both. 85.7% of the patients were very satisfied with the result of the operation.


CONCLUSIONS
The results prove the long term value of the operative treatment of kyphotic deformities of the spine in ankylosing spondylitis using Harrington's compression system, although meanwhile transpedicular screw fixation instead of hooks is used, as it is well known. It can now be said in detail, which long term influences vertebral osteotomies of the spine for correction have on specific activities and health conditions in these patients.
Halm
H
H
Zentrum für Wirbelsäulenchirurgie, Werner-Wicker-Klinik, Bad Wildungen-Reinhardshausen.
Metz-Stavenhagen
P
P
Schmitt
A
A
Zielke
K
K
D000203:Activities of Daily Living; D000328:Adult; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D016268:Internal Fixators; D007738:Kyphosis / Q000601:surgery*; D008124:Locomotion; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D011788:Quality of Life; D012189:Retrospective Studies; D013167:Spondylitis, Ankylosing / Q000601:surgery*; D011795:Surveys and Questionnaires
Operative Behandlung kyphotischer Wirbelsäulendeformitäten bei der Spondylitis ankylosans mit dem Harrington-Kompressionssystem: Langzeitergebnisse auf der Basis der MOPO-Skalen im Rahmen einer retrospektiven Fragebogenerhebung.