Asian Spine J.  2015 Oct;9(5):699-704. 10.4184/asj.2015.9.5.699.

Surgical Outcome for Hemodialysis-Related Upper Cervical Lesions

Affiliations
  • 1Department of Orthopaedics, Tokyo Women's Medical University, Tokyo, Japan. keijiwadajp@yahoo.co.jp

Abstract

STUDY DESIGN: A retrospective study. PURPOSE: To investigate the surgical outcome for hemodialysis-related upper cervical lesions. OVERVIEW OF LITERATURE: Surgical outcome of lower cervical lesions in patients undergoing hemodialysis has been reported. However, surgical outcome for upper cervical lesions in hemodialysis patients is unclear.
METHODS
Upper cervical lesions in nine patients undergoing hemodialysis were surgically treated. Mean age at surgery was 61.6 years (range, 52-68 years), and the mean follow-up period was 45.4 months (range, 2-98 months). Patients had undergone hemodialysis for an average of 25.3 years (range, 16-40 years) at surgery. Seven patients with destructive spondyloarthropathy (DSA) of the upper cervical spine were treated with atlantoaxial or occipitocervical fixation. Two patients with retro-odontoid pseudotumors were treated with C1 posterior arch resection alone. Japanese Orthopedic Association (JOA) scores for cervical myelopathy, postoperative complications, postoperative radiography, and preoperative and postoperative occipital pain were evaluated.
RESULTS
Mean preoperative and postoperative JOA score was 3.7 and 8.1, respectively. The seven patients with DSA had severe preoperative occipital pain that disappeared postoperatively. Postoperative radiography showed solid bone union in DSA cases and no instability in pseudotumor cases.
CONCLUSIONS
Satisfactory surgical outcome was observed for hemodialysis-related upper cervical lesions.

Keyword

Upper cervical spine; Surgical outcome; Hemodialysis; Destructive spondyloarthropathy

MeSH Terms

Asian Continental Ancestry Group
Follow-Up Studies
Humans
Orthopedics
Postoperative Complications
Radiography
Renal Dialysis
Retrospective Studies
Spinal Cord Diseases
Spine
Spondylarthropathies
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