Surgical Management of Cervical Spondyloarthropathy in Hemodialysis Patients
Panayiotis Spinos1, Charalambos Matzaroglou*, 2, Meni Partheni1, Deli Angeliki2, Menelaos Karanikolas3, Dimitrios Konstantinou4
Identifiers and Pagination:Year: 2010
First Page: 39
Last Page: 43
Publisher Id: TOORTHJ-4-39
Article History:Received Date: 2/12/2009
Revision Received Date: 21/12/2009
Acceptance Date: 22/12/2010
Electronic publication date: 19/1/2010
Collection year: 2010
open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/) which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.
Dialysis-related spondyloarthropathy is a rare cause of spinal deformity and cervical myelopathy. Optimal management of cervical spine spondyloarthropathy often requires circumferential reconstructive surgery, because affected patients typically have both the anterior column and the facet joints compromised. The occasional presence of noncontiguous or "skip lesions" adds an additional level of complexity to surgical management, because decompression and fusion in an isolated segment of neural compression can worsen spine deformity by applying increased stress to adjacent cervical spine segments. We report two cases of hemodialysis patients who presented with cervical myelopathy and initially had anterior cervical discectomy or corpectomy. Because symptoms recurred due to hardware failure, both patients required posterior spine fusion as well. In retrospect, because of the hardware failure, both of these patients might have benefited from a circumferential (combined anterior and posterior) cervical spine reconstruction as their initial treatment.