Spinos Panayiotis, Matzaroglou Charalambos, Partheni Meni, Deli Angeliki, Karanikolas Menelaos, Konstantinou Dimitrios
Department of Neurosurgery, Patras University Hospital, Rion, Greece.
Open Orthop J. 2010 Jan 19;4:39-43. doi: 10.2174/1874325001004010039.
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.
透析相关性脊柱关节病是脊柱畸形和颈椎脊髓病的罕见病因。颈椎脊柱关节病的最佳治疗通常需要进行环形重建手术，因为受影响的患者通常前柱和小关节均受损。偶尔出现的非连续性或“跳跃性病变”增加了手术治疗的复杂性，因为在孤立的神经受压节段进行减压和融合会因对相邻颈椎节段施加更大压力而加重脊柱畸形。我们报告了两例血液透析患者，他们均表现为颈椎脊髓病，最初接受了颈椎前路椎间盘切除术或椎体次全切除术。由于内固定失败导致症状复发，两名患者均还需要进行后路脊柱融合术。回顾来看，由于内固定失败，这两名患者最初若接受环形（前后联合）颈椎重建术可能会受益。
