Cervicooccipital hinge changes during longterm hemodialysis

A radiological survey of the upper cervical spine was carried out in all our unit cases treated by longterm hemodialysis for at least 8 years. There were 23 patients, 16 men, 7 women, whose mean age was 56.5 years. Among them, 9 had radiological changes in the cervicooccipital hinge. Bone cysts of various sizes were found in the dens (5 times), in the body of C2 (3 times) in the lateral masses of C1 (5 times) and in the anterior arch of C1 (3 times). A pauci-symptomatic odontoid fracture was demonstrated in 1 case. Only 3 patients suffered from cervical pain. Although no biopsy was performed, it is suggested that the bone cavities could be due to local amyloid deposits. beta 2 microglobulin serum levels were considerably increased in all cases.