Postoperative Complications and Survival Rate in Hemodialysis-Dependent Patients Undergoing Cervical Spine Surgery.
cervical spine
chronic glomerulonephritis
complication
destructive spondyloarthropathy
diabetes
hemodialysis
survival rate
Journal
Spine surgery and related research
ISSN: 2432-261X
Titre abrégé: Spine Surg Relat Res
Pays: Japan
ID NLM: 101718059
Informations de publication
Date de publication:
2022
2022
Historique:
received:
28
08
2021
accepted:
15
10
2021
entrez:
8
7
2022
pubmed:
9
7
2022
medline:
9
7
2022
Statut:
epublish
Résumé
Spine surgery is challenging in hemodialysis (HD)-dependent patients owing to their poor general condition. However, postoperative complications and the mortality and survival rates have not been specifically evaluated in a wide series. This study aimed to elucidate postoperative complications and the survival rate in cervical spine surgery in HD patients. This study included 109 HD patients (70 men, 39 women) who had undergone cervical spine surgery between July 1996 and May 2018. Based on radiological diagnosis, we divided them into the destructive spondyloarthropathy (DSA) and non-DSA groups. We investigated the causes of hemodialysis, postoperative complications, postoperative inpatient mortality rate, and survival rate. The DSA and non-DSA groups included 100 surgeries in 89 patients and 21 surgeries in 20 patients, respectively. The mean age at surgery was 62.9 years for the DSA and 55.9 years for the non-DSA group (P=0.97). The DSA group had a shorter hemodialysis period at surgery compared with the non-DSA group (21.7 vs. 26.5 years, P<0.05). The two most common causes of HD in both groups were chronic glomerulonephritis (DSA, 45%; non-DSA, 57.1%) and diabetes (DSA, 11%; non-DSA, 14.5%). Postoperative complications were observed in 23% (23/100) and 19% (4/21) of surgeries in the DSA and non-DSA groups, respectively (P=0.782). The total in-hospital mortality rate was 2.5% (3/121). The 1-, 3-, 5-, and 10-year postoperative survival rates of all patients were 89.6%, 75.5%, 67.1%, and 44.7%, respectively. The survival rates did not depend on the group (DSA vs. non-DSA), pre- and postoperative Japanese Orthopedic Association score for cervical myelopathy, hemodialysis period, sex, and age (P>0.05). However, significantly low survival rates were observed in HD caused by diabetes compared with that by chronic glomerulonephritis (P<0.001) and other causes (P<0.001). Cervical spine surgery in HD patients is associated with postoperative complications. The postoperative survival rate was found to be low if the cause of hemodialysis was diabetes.
Identifiants
pubmed: 35800630
doi: 10.22603/ssrr.2021-0173
pmc: PMC9200424
doi:
Types de publication
Journal Article
Langues
eng
Pagination
233-239Informations de copyright
Copyright © 2022 by The Japanese Society for Spine Surgery and Related Research.
Déclaration de conflit d'intérêts
Conflicts of Interest: The authors declare that there are no relevant conflicts of interest.
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