Surgical Management for Destructive Atlantoaxial Spondyloarthropathy in Long-Term Hemodialysis Patients

详细信息    查看全文

• 作者：Je Hoon Jeong¹ ; Hee Kyung Kim² ; Soo Bin Im¹ ; ^{isbrzw@gmail.com}
• 关键词：Hemodialysis ; Spondyloarthropathy ; Surgical management
• 刊名：World Neurosurgery
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：97
• 期：Complete
• 页码：753.e7-753.e16
• 全文大小：2831 K
• 卷排序：97

文摘

Atlantoaxial spondyloarthropathy most often results from rheumatoid arthritis, cancer metastasis, or basilar invagination. Dialysis-related spondyloarthropathy is a rare cause of spinal deformity and cervical myelopathy at the atlantoaxial joint. We report 2 patients on long-term hemodialysis who presented with atlantoaxial spondyloarthropathy.Case DescriptionTwo patients with end-stage renal failure presented with a history of progressively worsening neck pain, motion limitation, and gait disturbance. In both patients, radiologic findings showed a bone-destroying soft tissue mass lateral to C1 and C2, compressing the spinal cord and causing atlantoaxial instability. We performed a C1 laminectomy and C12 transarticular screw fixation and biopsied the osteolytic mass. The neck pain, hand numbness, and gait disturbance improved.ConclusionsAlthough the surgical management of these patients involves many challenges, appropriate decompression and fusion surgery is an effective treatment option.