Uremic Patients Risk Spinal Surgery Complications

Higher complication rate emphasizes need for attention to pre-, peri-, and postsurgical care

WEDNESDAY, April 20 (HealthDay News) -- Uremic patients undergoing posterior instrumented lumbar spinal surgery have similar solid fusion rates, but are at increased risk of complications compared to controls, according to a study published in the April 15 issue of Spine.

Yi-Hsun Yu, M.D., from the Chang Gung Memorial Hospital in Taiwan, and colleagues reviewed the medical records, laboratory data, image studies, and functional outcomes of 34 uremic patients under maintenance hemodialysis, who underwent posterior instrumented lumbar spinal surgery. Surgical outcomes were compared to a control group.

The investigators found that, in uremic patients, preoperative hemoglobin was significantly lower, and perioperative packed red blood cell transfusions were significantly higher. The complication rate was significantly higher in the uremic group. The solid fusion rates, visual analog pain scale, and general outcome assessment were not significantly different between the two groups. There was a significantly lower sold fusion rate in the three-level fusion compared to the single-level and two-level fusion.

"The more extensive the instrumented lumbar spinal surgery is for uremic patients, the more closely surgeons should pay attention to preoperative preparation, perioperative management, and postoperative care," the authors write.

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