Kidney and Metabolic Bone Diseases Vol.29 No.3(7)

Theme Dialysis related amyloidosis and associated bone and joint disorders
Title Surgical treatment of spinal lesions in patients with maintenance hemodialysis
Publish Date 2016/07
Author Kuniyoshi Tsuchiya Department of Orthopedic Surgery, JCHO Kyushu Hospital
[ Summary ] The pathologic changes caused by hemodialysis (HD) are divided into two major categories, which consists of dystrophic changes and hypertrophic changes. When performing spinal surgery on patients undergoing HD, those conditions should be thoroughly considered and appropriate surgical procedures should be established. Practically, soft tissue preservation is important when decompression is planned. When performing fusion surgery, appropriate anchor placement and selection of proper fusion levels is mandatory. Recovery of neurological symptoms are generally acceptable. However, implant loosening was seen in approximately 3-40 % of our patients, suggesting poor bone quality in HD patients. Treatment of osteoporosis should be considered when caring for these patients.
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