表现为严重后凸畸形且无疼痛的强直性脊柱炎：病例报告和文献综述
Ankylosing Spondylitis Presenting as a Severe Kyphotic Deformity Without Pain: A Case Report and Literature Review.
摘要(中文译文)
强直性脊柱炎（AS）是一种主要累及中轴骨骼和骶髂关节的慢性炎症性疾病。进行性结构重塑可导致韧带骨赘形成、脊柱强直及特征性“竹节样脊柱”外观。在晚期阶段，可出现脊柱畸形和功能障碍。我们报告一例32岁男性患者，表现为进行性脊柱畸形及外观困扰，当前无明显疼痛。该畸形自青春期起逐渐发展，始于15岁，初期伴有交替性髋部疼痛。临床检查显示明显的颈胸段过度后凸、矢状面失衡、左肩抬高及右侧骨盆倾斜。脊柱活动度评估显示严重受限，Schober指数为1 cm，胸廓扩张度降至4 cm。影像学检查显示竹节样脊柱外观，伴后部椎体元件融合，骨盆X线摄影显示双侧骶髂关节强直。实验室检查证实HLA-B27阳性。肺功能检查显示限制性通气模式。Bath强直性脊柱炎疾病活动指数（BASDAI）和Bath强直性脊柱炎功能指数（BASFI）评分分别提示具有临床意义的疾病活动度和中度功能障碍。该患者被纳入多学科管理方案，包括运动和呼吸康复、风湿科随访，并转诊进行固定性后凸畸形的手术评估。本病例突出了AS以脊柱畸形而非活动性疼痛为主要表现的晚期表现形式。它强调了早期识别和定期评估脊柱活动度的重要性，以防止不可逆的结构损伤和长期功能障碍。
Abstract
Ankylosing spondylitis (AS) is a chronic inflammatory disease predominantly affecting the axial skeleton and sacroiliac joints. Progressive structural remodeling may lead to syndesmophyte formation, spinal ankylosis, and the characteristic "bamboo spine" appearance. In advanced stages, spinal deformities and functional impairment may occur. We report the case of a 32-year-old male presenting with progressive spinal deformity and cosmetic concern without significant current pain. The deformity had progressively developed since adolescence, beginning at the age of 15, and was initially associated with alternating hip pain. Clinical examination revealed marked cervicothoracic hyperkyphosis, sagittal imbalance, left shoulder elevation, and right pelvic tilt. Spinal mobility assessment demonstrated severe limitation, with a Schober index of 1 cm and thoracic expansion reduced to 4 cm. Imaging studies revealed a bamboo spine appearance with fusion of the posterior vertebral elements, while pelvic radiography demonstrated bilateral sacroiliac ankylosis. Laboratory investigations confirmed HLA-B27 positivity. Pulmonary function tests showed a restrictive ventilatory pattern. Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) scores indicated clinically significant disease activity and moderate functional impairment, respectively. The patient was enrolled in a multidisciplinary management program including motor and respiratory rehabilitation, rheumatological follow-up, and referral for surgical evaluation of the fixed kyphotic deformity. This case highlights an advanced presentation of AS presenting primarily with spinal deformity rather than active pain. It emphasizes the importance of early recognition and regular assessment of spinal mobility in order to prevent irreversible structural damage and long-term functional impairment.
如何引用
AMA
Hajar Fahli, Elgmiri Hajar, Sara Skalli, Samia Karkouri. Ankylosing Spondylitis Presenting as a Severe Kyphotic Deformity Without Pain: A Case Report and Literature Review.. Cureus. 2026; doi:10.7759/cureus.110310.
APA
Hajar Fahli, Elgmiri Hajar, Sara Skalli, Samia Karkouri (2026). Ankylosing Spondylitis Presenting as a Severe Kyphotic Deformity Without Pain: A Case Report and Literature Review.. Cureus. https://doi.org/10.7759/cureus.110310
GB/T 7714
Hajar Fahli, Elgmiri Hajar, Sara Skalli, Samia Karkouri. Ankylosing Spondylitis Presenting as a Severe Kyphotic Deformity Without Pain: A Case Report and Literature Review.[J]. Cureus, 2026 doi:10.7759/cureus.110310.
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