Central diabetes insipidus after staged spinal surgery.
Benjamin P Rosenbaum1, Michael P Steinmetz2
1Department of Neurosurgery, Center for Spine Health, Cleveland Clinic Foundation, Cleveland, Ohio.
Global Spine Journal
|January 18, 2014
Summary
A rare case of central diabetes insipidus (DI) occurred after spinal fusion surgery. Prompt diagnosis and desmopressin acetate (DDAVP) treatment resolved the hypernatremia and polyuria, highlighting DI as a potential complication.
Area of Science:
- Neurosurgery
- Endocrinology
- Spinal Surgery
Background:
- Diabetes insipidus (DI) is infrequently reported after instrumented spinal fusion.
- Hyponatremia, often iatrogenic due to Syndrome of Inappropriate Antidiuretic Hormone release, is more common post-spine surgery.
Observation:
- A 57-year-old woman developed hypernatremia (157 mmol/L) and polyuria on postoperative day 3 after a two-stage scoliosis correction.
- Endocrinology consultation confirmed central DI.
Findings:
- The patient's symptoms resolved with desmopressin acetate (DDAVP) treatment.
- DDAVP was temporarily administered and subsequently weaned off.
Implications:
- Central DI should be considered in patients presenting with hypernatremia after extensive spinal surgery.
- Timely diagnosis and management with agents like DDAVP are crucial for patient recovery.
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