Spinal Surgery in Patients With End-Stage Renal Disease Undergoing Hemodialysis Therapy
Abstract
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…
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