Surgical management of spinal disease in renal recipients

Abstract

The survival of renal recipients improved dramatically and long-term survival of renal graft patients is common, which in turn increases the chance of these patients requiring spinal surgery. However, there are few appropriate reports about the results of spine surgery on renal recipients. This study was undertaken to analyze the authors' experience of spine surgery after renal transplantation. Thirty-two renal recipients who underwent spine surgery with regular follow-up of more than 24 months were included in this study. The patients' medical records and the radiological reports were reviewed retrospectively and their postoperative conditions were evaluated during their regular visits or by telephone. The mean duration from the renal transplantation to spinal surgery was 6 +/- 1.2 yr. Among spinal diseases of renal recipients, there were 23 cases of degenerative spinal diseases, seven cases of vertebral compression fracture, and two spinal cord tumors. The operation methods were conventional spine surgery with or without bone fusion (27 cases), percutaneous vertebroplasty (three cases) and tumor resection (two cases). The mean values of the Prolo scale in the preoperative (4.5 +/- 0.3) and postoperative (7.4 +/- 0.4) period showed significant clinical improvement after the operation. Postoperative renal function was not deteriorated in any patients and there were no major complications. Spine surgery can be performed with acceptable clinical results and without major complications in renal recipients. Spine surgery has no aggravating effect on the patients' renal function. Surgery is a valuable, safe option for the treatment of spinal disease in this rare distinct group of patients.