Yabe Yutaka, Ishikawa Keisuke, Kurosawa Daisuke, Murakami Eiichi, Aizawa Toshimi
Department of Orthopaedic Surgery, National Hospital Organization Sendai Nishitaga Hospital, Sendai, Japan.
Department of Orthopaedic Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, 980-8574, Japan.
Eur Spine J. 2025 Jan;34(1):43-49. doi: 10.1007/s00586-024-08578-y. Epub 2024 Nov 26.
Destructive spondyloarthropathy (DSA) is a serious complication of long-term haemodialysis; it commonly occurs in the cervical spine and has been investigated in cervical lesions. Although DSA of the lumbar spine has been reported, only few studies have investigated this, and the characteristics of patients with lumbar DSA are unclear. The present study aimed to elucidate the prevalence of DSA and its clinical characteristics in patients with DSA in the lumbar spine using computed tomography (CT) images of the patients who underwent lumbar spine surgery.
Consecutive patients undergoing haemodialysis who underwent lumbar spine surgery (n = 67) were assessed. DSA was diagnosed using CT images, and the patients were divided into non-DSA and DSA groups. The differences in the clinical characteristics of the patients in the two groups were analysed.
The prevalence of patients diagnosed with DSA was 31.3%. The mean intra- and inter-observer kappa values of DSA classification using CT images were 0.68 and 0.53, respectively. Although there were no significant differences in the age, sex, body mass index, reason for lumbar surgery, disease causing haemodialysis, age at the start of haemodialysis, or duration of haemodialysis between the non-DSA and DSA groups, the duration of haemodialysis tended to be longer in the DSA group.
Among patients on haemodialysis who underwent lumbar spine surgery, the prevalence of patients with DSA was 31.3%. Classification of DSA using CT showed moderate-to-substantial agreement. Patients with DSA tended to have a longer haemodialysis duration.
破坏性脊椎关节病（DSA）是长期血液透析的一种严重并发症；它常见于颈椎，且已有针对颈椎病变的研究。虽然已有腰椎DSA的报道，但仅有少数研究对此进行过调查，腰椎DSA患者的特征尚不清楚。本研究旨在利用接受腰椎手术患者的计算机断层扫描（CT）图像，阐明腰椎DSA患者中DSA的患病率及其临床特征。
对连续接受腰椎手术的血液透析患者（n = 67）进行评估。使用CT图像诊断DSA，并将患者分为非DSA组和DSA组。分析两组患者临床特征的差异。
诊断为DSA的患者患病率为31.3%。使用CT图像进行DSA分类时，观察者间和观察者内的平均kappa值分别为0.68和0.53。虽然非DSA组和DSA组在年龄、性别、体重指数、腰椎手术原因、导致血液透析的疾病、开始血液透析的年龄或血液透析持续时间方面无显著差异，但DSA组的血液透析持续时间往往更长。
在接受腰椎手术的血液透析患者中，DSA患者的患病率为31.3%。使用CT对DSA进行分类显示出中度到高度的一致性。DSA患者的血液透析持续时间往往更长。
