Surgical therapy for dialysis-related spondyloarthropathy: Review of 30 cases

Surgical therapy for dialysis-related spondyloarthropathy was investigated regarding its spinal manifestation. Between August 1985 and May 1998, 31 op erations were performed on 16 male and 14 female patients; of these, 17 had cervical and 13 had lumbar spinal disorders. The average patient age was 5 9 years. The average period of hemodialysis was 14.8 years. Twenty-eight of 30 patients had cystic bone lesions and 24 had carpal tunnel syndrome. Fou r major postoperative complications occurred: death from paralysis and resp iratory distress, severe kyphosis from the collapse of the grafted bone, de ep infection from instrumentation, and wire breakage and bone fusion failur e. Postoperative results with an average follow-up period of 2.7 years were good in 19 cases (63%), fair in 8 cases (27%), and poor in 3 cases (10%). As yet, surgical intervention for dialysis-related spondyloarthropathy is s till regarded as a noncurative treatment; furthermore, the anterior approac h to the cervical spine has a high risk for postoperative complications.