Destructive spondyloarthropathy (DSA) in patients on hemodialysis due to chronic renal failure was first reported by Kuntz et al. in 1984. As far as we know, there are few reports on surgical treatment for lumbar lesion. We here report two patients with DSA of the lumbar spine treated successfully. Both patients had gait disturbance because of severe pain, whose X-ray of the lumbar spine showed narrowing of the disc space between L4 and L5 and instability of the vertebral body. We performed posterolateral fusion combined with posterior lumbar interbody fusion. Rigid fusion seems to be an optimal surgical option for these patients. However, it is often difficult because of the poor general conditions of the patients. It is very important to select the appropriate operative method according to the patients conditions.
