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Long-term follow up of surgical outcomes in patients with cervical disorders undergoing hemodialysis.

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Title: Long-term follow up of surgical outcomes in patients with cervical disorders undergoing hemodialysis.
Authors: Sudo, Hideki Browse this author
Ito, Manabu Browse this author
Abumi, Kuniyoshi Browse this author
Kotani, Yoshihisa Browse this author
Takeuchi, Tatsuto Browse this author
Yasui, Keigo Browse this author
Minami, Akio Browse this author →KAKEN DB
Keywords: hemodialysis
cervical spine
surgical outcome
Issue Date: Oct-2006
Publisher: American Association of Neurological Surgeons
Journal Title: Journal of Neurosurgery: Spine
Volume: 5
Issue: 4
Start Page: 313
End Page: 319
PMID: 17048767
Abstract: OBJECT. As increasing numbers of patients receive long-term hemodialysis, the number of reports regarding hemodialysis-related cervical spine disorders has also increased. However, there have been few reports summarizing the surgical results in patients with these disorders. The objective of this study was to evaluate the long-term follow up and clinical results after surgical treatment of cervical disorders in patients undergoing hemodialysis. METHODS. Seventeen patients in whom surgery was performed for cervical spine disorders while they received long-term hemodialysis therapy were enrolled in this study. Of these, 15 underwent follow-up review for more than 3 years after surgery, and these represent the study population. The remaining two patients died of postoperative sepsis. The average follow-up period was 120 months. Five patients without spinal instability underwent spinal cord decompression in which bilateral open-door laminoplasty was performed. Ten patients with destructive spondyloarthropathy (DSA) underwent reconstructive surgery involving pedicle screw (PS) fixation. In eight patients in whom posterior instrumentation was placed, anterior strut bone grafting was performed with autologous iliac bone to treat anterior-column destruction. Marked neurological recovery was obtained in all patients after the initial surgery. In the mobile segments adjacent to the site of previous spinal fusion, the authors observed progressive destructive changes with significant instability in four patients (40%) who underwent circumferential spinal fusion. No patients required a second surgery after laminoplasty for spinal canal stenosis without DSA changes. CONCLUSIONS. Cervical PS-assisted reconstruction provided an excellent fusion rate and good spinal alignment. During the long-term follow-up period, however, some cases required extension of the spinal fusion due to the destructive changes in the adjacent vertebral levels. Guidelines or recommendations to overcome these problems should be produced to further increase the survival rates of patients undergoing hemodialysis.
Rights: The final version of the paper was published in JOURNAL OF NEUROSURGERY-SPINE, 5 (4). For reuse of any of the materials, including editorial copy, figures, or tables please contact the Journal of Neurosurgery at jneuro@virginia.edu
Type: article (author version)
URI: http://hdl.handle.net/2115/14891
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 須藤 英毅

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