RESEARCH ARTICLE


Surgical Management of Cervical Spondyloarthropathy in Hemodialysis Patients



Panayiotis Spinos1, Charalambos Matzaroglou*, 2, Meni Partheni1, Deli Angeliki2, Menelaos Karanikolas3, Dimitrios Konstantinou4
1 Department of Neurosurgery, Patras University Hospital, Rion, Greece
2 Department of Orthopaedic Surgery, Patras University Hospital, Rion, Greece
3 Department of Anaesthesiology and Critical Care Medicine, University of Patras School of Medicine, Rion, Greece
4 Department of Neurosurgery, University of Patras School of Medicine, Rion, Greece


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Creative Commons License
© Spinos et al.; Licensee Bentham Open.

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.

* Address correspondence to this author at the Department of Orthopaedics, University of Patras, Rion, Greece; Tel: +30 2610 999556; Fax: +30 2610 994579; E-mail: orthopatras@yahoo.gr


Abstract

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.

Keywords: Hemodialysis, spondyloarthropathy, surgical management..