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Related Experiment Videos

Cervicooccipital hinge changes during longterm hemodialysis.

J C Gerster1, P A Carruzzo, J M Ginalski

  • 1Rheumatology and Rehabilitation Center, University Hospital (CHUV), Lausanne, Switzerland.

The Journal of Rheumatology
|November 1, 1989
PubMed
Summary

Long-term hemodialysis patients show cervical spine changes, including bone cysts and fractures. Elevated beta-2 microglobulin suggests amyloid deposits may cause these radiological findings.

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Area of Science:

  • Nephrology
  • Radiology
  • Orthopedics

Background:

  • Long-term hemodialysis is a vital treatment for end-stage renal disease.
  • Patients undergoing chronic hemodialysis may develop various systemic complications.
  • The upper cervical spine is a potential site for pathology in these patients.

Observation:

  • A radiological survey focused on the upper cervical spine in 23 patients on hemodialysis for over 8 years.
  • Radiological changes were observed in 9 patients, primarily in the cervicooccipital region.
  • Bone cysts were noted in the dens, C2 body, and C1 lateral masses and arch.

Findings:

  • Bone cysts were the most common finding, with one case of a pauci-symptomatic odontoid fracture.
  • Only 3 patients reported cervical pain, indicating asymptomatic or pauci-symptomatic presentation.

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  • Significantly increased beta-2 microglobulin serum levels were detected in all patients.

    • Implications:

    • The findings suggest a link between long-term hemodialysis and upper cervical spine abnormalities.
    • Local amyloid deposits are hypothesized as the cause of bone cavities, supported by elevated beta-2 microglobulin.
    • Further investigation is warranted to confirm the etiology and clinical significance of these radiological changes.