Cassó-Troche Lloyd R, Echavarría-Uceta Jesús Antonio, Quiñones-Robles Joan, Haché-Pagan Caran, Herrera Ironelis, Encarnación Johnson, la Rosa Silvestre De, la Cruz Dolores Mejía De, Rojas Limber, Vásquez Pedro Pablo Díaz
Department of Neurosurgery, Hospital General de la Plaza de la Salud, Santo Domingo, Dominican Republic.
Department of Research, Hospital General de la Plaza de la Salud, Santo Domingo, Dominican Republic.
Surg Neurol Int. 2022 Nov 25;13:549. doi: 10.25259/SNI_821_2022. eCollection 2022.
Spondylodiscitis is a potentially catastrophic complication in patients on hemodialysis. It is slow and insidious onset and nonspecific symptoms have contributed to the late detection of this infectious process. Here, we reviewed the clinical characteristics and outcomes for patients on hemodialysis who developed spondylodiscitis who were diagnosed with spondylodiscitis.
From 2011 to 2021, 11 (0.4%) of 2557 patients on hemodialysis were diagnosed with spondylodiscitis based on clinical symptoms, patients averaged 56.9 years of age, seven were male, and they presented with fever in just two cases. The most frequent comorbidities included hypertension (ten patients) and diabetes mellitus (seven patients). Here, we reviewed the clinical, radiological (i.e., MR scans), laboratory markers, and treatment choices (i.e., nonsurgical vs. surgical) for these 11 hemodialysis patients.
Ten of the 11 patients underwent spinal surgery, and five were later readmitted for recurrent of infections. There was just one nonsurgical mortality.
For patients on hemodialysis, the new-onset of spinal pain may signal the onset of spondylodiscitis which should be rapidly diagnosed with MR studies and managed in a timely fashion either with antibiotic therapy and/or with surgery/antibiotics.
脊椎椎间盘炎是血液透析患者中一种潜在的灾难性并发症。其发病缓慢且隐匿，非特异性症状导致了这种感染性疾病的诊断延迟。在此，我们回顾了诊断为脊椎椎间盘炎的血液透析患者的临床特征及预后情况。
2011年至2021年期间，2557例血液透析患者中有11例（0.4%）根据临床症状被诊断为脊椎椎间盘炎，患者平均年龄56.9岁，7例为男性，仅2例出现发热症状。最常见的合并症包括高血压（10例患者）和糖尿病（7例患者）。在此，我们回顾了这11例血液透析患者的临床、影像学（即磁共振扫描）、实验室指标及治疗选择（即非手术治疗与手术治疗）情况。
11例患者中有10例接受了脊柱手术，5例后来因感染复发再次入院。仅1例非手术治疗患者死亡。
对于血液透析患者，新发的脊柱疼痛可能预示着脊椎椎间盘炎的发生，应通过磁共振检查迅速诊断，并及时采用抗生素治疗和/或手术/抗生素联合治疗。
