Surgical Outcome for Hemodialysis-Related Upper Cervical Lesions

Wada, Keiji; Murata, Yoshinori; Kato, Yoshiharu

doi:10.4184/asj.2015.9.5.699

Cited by 8 publications

(8 citation statements)

References 15 publications

(39 reference statements)

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“…16 The inflammatory deposits and amyloid can subsequently lead to development of retro-odontoid pseudotumor. 17 Lastly, there have been prior case reports of pigmented villonodular synovitis (PVNS) as a cause of retro-odontoid pseudotumor. 18 PVNS is a proliferative, destructive, non-malignant tumor of synovial membranes that can affect the cervical spine in up to 36% of cases.…”

Section: A C C E P T E D a R T I C L Ementioning

confidence: 99%

“…CPPD is difficult to distinguish from other etiologies on MRI, alone. Tojo et al 16 Wada et al 17 Hemodialysis-associated amyloidosis causes accumulation of β-2 microglobulin in the form of amyloid fibrils and inflammatory deposits in joints and surrounding structures Finn et al 18 Roguski et al 19 Chhieng et al 20 Giannini et al 21 PVNS proliferative, destructive, non-malignant tumor of synovial membranes with inflammation and joint degeneration; up to 36% occurrences in the cervical spine.…”

Section: A C C E P T E D a R T I C L Ementioning

confidence: 99%

“…These fibrils can accumulate in the cervical spine, and deposit in the craniocervical junction [ 15 ]. The inflammatory deposits and amyloid can subsequently lead to development of retro-odontoid pseudotumor [ 16 ]. Lastly, there have been prior case reports of pigmented villonodular synovitis (PVNS) as a cause of retro-odontoid pseudotumor [ 17 ].…”

Section: Pathophysiologymentioning

confidence: 99%

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Retro-Odontoid Pseudotumor Formation in the Context of Various Acquired and Congenital Pathologies of the Craniovertebral Junction and Surgical Techniques

et al. 2021

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Retro-odontoid pseudotumor formation consists of an abnormal growth of granulation tissue typically posterior to the odontoid process, resulting as a manifestation of atlantoaxial instability. This instability can occur as a result of conditions ranging from severe mechanical trauma to metabolic disease or autoimmune conditions such as rheumatoid arthritis. A pseudotumor may impinge on the spinal nerves or even the spinal cord and brainstem, manifesting symptoms from severe neck pain to cervicomedullary compression or myelopathy, and in some cases even sudden death. The objective of this review is to consolidate the findings in published case reports and relevant prior literature reviews regarding the formation of retro-odontoid pseudotumor. We address the pathophysiology involved in acquired and congenital pseudotumor formation, including those associated with rheumatoid arthritis (panni). Additionally, we discuss past and current operative techniques designed to curtail and ultimately regress a retro-odontoid pseudotumor and pannus. Surgical techniques that are addressed include ventral decompression (both transoral and transnasal), dorsal decompression, and indications for posterior instrumentation in pannus formation, particularly in cases that may be sufficiently treated in lieu of an anterior approach. Finally, we will examine the role of external orthoses as both a method of conservative treatment as well as a potential adjunct to the aforementioned surgical procedures.

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Section: A C C E P T E D a R T I C L Ementioning

confidence: 99%

Section: A C C E P T E D a R T I C L Ementioning

confidence: 99%

Section: Pathophysiologymentioning

confidence: 99%

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Retro-Odontoid Pseudotumor Formation in the Context of Various Acquired and Congenital Pathologies of the Craniovertebral Junction and Surgical Techniques

et al. 2021

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“…Apart from DSA, long-term HD patients may also develop spinal canal stenosis due to amyloid deposition and calcification in the spinal canal with scarce X-ray changes 3,6,7 . In addition, several reports have described upper cervical lesions in long-term HD patients [8][9][10][11] . The upper cervical lesions include periodontoid pseudotumor and atlantoaxial or occipitoatlantal DSA [8][9][10][11] .…”

Section: Introductionmentioning

confidence: 99%

Postoperative Complications and Survival Rate in Hemodialysis-Dependent Patients Undergoing Cervical Spine Surgery

Wada

Tamaki

Inoue

et al. 2022

Spine Surg Relat Res

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Introduction 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. Methods 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. Results 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). Conclusions 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.

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“…One of the most catastrophic complications of anterior cervical discectomy and fusion (ACDF) is postoperative hemorrhage, which may result in dyspnea, respiratory arrest, and death [ 1 2 3 4 5 6 ]. Surgeons need to be alert for this complication and try their best to prevent it [ 7 8 9 10 11 ]. One of the various methods to minimize postoperative hemorrhage is the local application of a hemostatic agent.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of a Topical Gelatin-Thrombin Matrix Sealant in Reducing Postoperative Drainage Following Anterior Cervical Discectomy and Fusion

Lee

Han

et al. 2015

Asian Spine J

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Study Design:Retrospective fusion level(s)-, age-, and gender-matched analysis. Purpose: To determine whether the application of a topical gelatin-thrombin matrix sealant (Floseal) at the end of anterior cervical discectomy and fusion (ACDF) can reduce the amount of postoperative hemorrhage. Overview of Literature: The effect of the matrix sealant in decreasing postoperative hemorrhage following ACDF has not been reported. Methods: Matrix sealant was (n=116, study group) or was not applied (n=58, control group) at the end of ACDF. Patients were selected by 1:2 matching criteria of fusion level(s), age, and gender. Seven parameters described below were compared between the two groups. Results: The total drain amount for the first 24 hours (8±9 versus 27±22 mL), total drain amount until the 8-hour drainage decreased to ≤10 mL (8±10 versus 33±26 mL), and the total drain amount until 6 AM on the first postoperative day (7±8 versus 24±20 mL) were significantly lower in the study group than the control group (all p<0.001). The time for the 8-hour drainage to decrease to ≤10 mL was significantly lower in the study group (10±5 versus 26±14 hours, p<0.001). The 8-hour drainage decreased to ≤10 mL on the operation day in most patients (88%) in the study group versus mostly on the first (48%) or second (33%) postoperative day in the control group (p<0.001). The total drain amount until 6 AM on the first postoperative day was 0 mL in 43% of patients in the study group and in 7% in the control group (p<0.001). No patient in either group required hematoma evacuation.

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Surgical Outcome for Hemodialysis-Related Upper Cervical Lesions

Cited by 8 publications

References 15 publications

Retro-Odontoid Pseudotumor Formation in the Context of Various Acquired and Congenital Pathologies of the Craniovertebral Junction and Surgical Techniques

Retro-Odontoid Pseudotumor Formation in the Context of Various Acquired and Congenital Pathologies of the Craniovertebral Junction and Surgical Techniques

Postoperative Complications and Survival Rate in Hemodialysis-Dependent Patients Undergoing Cervical Spine Surgery

Efficacy of a Topical Gelatin-Thrombin Matrix Sealant in Reducing Postoperative Drainage Following Anterior Cervical Discectomy and Fusion

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