Peculiarities of Spondylitis in the Patients Undergoing Program Hemodialysis (Case Report)

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Abstract

Relevance. The surgical treatment of spinal diseases and injuries in the patients on hemodialysis is one of the most complicated problems of the spine surgery, since such a surgery is associated with an increased risk of infectious complications and perioperative mortality. The case description. A 59-year-old female came to the clinic complaining back pain. Th8-9 vertebrae spondylitis complicated by an epidural and paravertebral abscess with pertinent neurological disorders and bilateral pneumonia were diagnosed. The patient had been on hemodialysis for 18 years due to the end-stage chronic kidney disease complicated by uremic osteodystrophy. The surgical debridement and stabilization of the spine were performed in one stage posterior approach using a titanium mesh implant in combination with autologous bone and posterior instrumentation. A regression of neurological disorders and the pain syndrome relief were achieved. In the late postoperative period, the instability of the posterior fixation developed twice, requiring restabilization. Within the following 3.5 years after the operation, the pain syndrome had not returned. Conclusion. The presence of equipment for hemodialysis and a multidisciplinary approach allow to achieve the positive results in the surgical treatment of inflammatory diseases of the spine in the patients with endstage chronic kidney disease.

About the authors

M. A. Mushkin

Pavlov First St. Petersburg State Medical University

Author for correspondence.
Email: mikhail_mushkin@mail.ru

Mikhail А. Mushkin — Assistant, Department of Traumatology and Orthopedics

St. Petersburg

Россия

A. K. Dulaev

Pavlov First St. Petersburg State Medical University; Dzhanelidze Saint Petersburg Scientific Research Institute of Emergency Medicine, St. Petersburg

Email: fake@neicon.ru

Alexander K. Dulaev — Dr. Sci. (Med.), Professor, Head of Department of Traumatology and Orthopedics, St. Petersburg Dzhanelidze Research Institute of Emergency Medicine; Head of the Department of Traumatology and Orthopedics, Pavlov First St. Petersburg State Medical University

St. Petersburg

Россия

A. N. Tsed

Pavlov First St. Petersburg State Medical University

Email: fake@neicon.ru

Alexander N. Tsed — Cand. Sci. (Med.), Assistant Professor, Department of Traumatology and Orthopedics, Head of Department of Traumatology and Orthopedics No. 2

St. Petersburg

Россия

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