We reviewed seven hemodialysis patients who required spinal surgery. All were male with an average age of 59 years. They consisted of four cervical and three lumbar spinal diseases. The duration of hemodialysis ranged from four years and eight months to 26 years and 9 months, with a mean of 18 years and 5 months.
Two cases of cervical destructive spondyloarthropathy underwent posterior spinal fusion with laminoplasty. One case of cervical myelopathy and one of epidural calcification were underwent laminoplasty alone. Three cases of lumbar diseases primarily underwent only decompression procedures. The clinical results of all cases improved soon after surgery, However, the condition of one cervical case without fusion and two lumbar cases deteriorated with time. One lumbar case which received additional instrumented fusion surgery died on the day following the surgery due to presumable heart attack.
From this study, decompression surgery combined with spinal fusion is thought to be the profered treatment when attempting spinal surgery on hemodialysis patients. However, we should consider not only spinal pathology but also general conditions of the patient due to the presence of asymptomatic myocardial ischemic lesions that did not show any abnormal findings in the usual preoperative screening.