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Spinal surgery in patients with end-stage renal disease undergoing hemodialysis therapy

 In-Ho Han  ;  Keun-Su Kim  ;  Hyeong-Cheon Park  ;  Dong-Kyu Chin  ;  Byung-Ho Jin  ;  Young-Sul Yoon  ;  Jung-Yong Ahn  ;  Yong-Eun Cho  ;  Sung-Uk Kuh 
 SPINE, Vol.34(18) : 1990-1994, 2009 
Journal Title
Issue Date
Aged ; Female ; Follow-Up Studies ; Humans ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/therapy* ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; Renal Dialysis* ; Retrospective Studies ; Spinal Diseases/complications ; Spinal Diseases/surgery* ; Spinal Fusion/methods*
spinal surgery ; end-stage renal disease ; hemodialysis ; bone fusion ; osteoporosis
STUDY DESIGN: Case series retrospective review. OBJECTIVE: To present the surgical treatment guideline for spinal diseases with end-stage renal disease (ESRD) patients undergoing hemodialysis. SUMMARY OF BACKGROUND DATA: Treatment for spinal diseases with ESRD patients in is a special clinical challenge because of complex medical and clinical problems. METHODS: We retrospectively reviewed 12 patients who underwent spinal surgeries among patients with chronic renal failure at our hospital from May 2000 to September 2007. The medical records and radiologic findings for these patients were reviewed and concomitant medical diseases, laboratory findings, pre- and postoperative care, clinical outcomes, and complications were investigated. RESULTS: One patient died of pneumonia and sepsis 2 months after fusion surgery. Other postoperative complications included postoperative delirium in 3 patients and terminal ileitis and delayed primary spondylodiscitis in 1 patient each. There were no postoperative wound infections associated with the spinal surgery.The preoperative mean visual analogue scale score was 7.9 +/- 0.61, which improved to 2.2 +/- 1.25 at the time of final follow-up for 11 patients. Among 5 patients who underwent fusion surgery, solid bone fusion was achieved in only 3 patients and included those who underwent posterior lumbar interbody fusion with pedicle screw fixation. In 2 patients who underwent posterior lumbar interbody fusion with cage alone, solid fusion was not achieved. In 1 of 2 patients who underwent anterior cervical fusion with plating, solid fusion was achieved. The overall fusion rate was 57.1% in patients with ESRD undergoing hemodialysis. CONCLUSION: Spinal surgeries in ESRD patients undergoing hemodialysis can be performed with acceptable outcomes; however, the complication rates and mortality rates are relatively high and the fusion rate is low. To obtain a better outcome, multiple factors such as comorbid medical diseases, laboratory abnormalities, and osteoporosis should be carefully considered.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Neurosurgery (신경외과학교실) > 1. Journal Papers
Yonsei Authors
Kuh, Sung Uk(구성욱) ORCID logo https://orcid.org/0000-0003-2566-3209
Kim, Keun Su(김근수) ORCID logo https://orcid.org/0000-0002-3384-5638
Park, Hyeong Cheon(박형천) ORCID logo https://orcid.org/0000-0002-1550-0812
Ahn, Jung Yong(안정용)
Yoon, Young Sul(윤영설)
Cho, Yong Eun(조용은) ORCID logo https://orcid.org/0000-0001-9815-2720
Chin, Dong Kyu(진동규) ORCID logo https://orcid.org/0000-0002-9835-9294
Jin, Byung Ho(진병호)
Han, In Ho(한인호)
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