title: Percutaneous nephrolithotomy in spinal cord neuropathy patients: a single institution experience.
abstract: OBJECTIVE
  Patients with spinal neuropathy are at an increased risk for urolithiasis. Data on percutaneous nephrolithotomy (PCNL) in this population are limited. Our objective is to review our experience in managing stones with PCNL in patients with spinal neuropathy.
  
  
  METHODS
  Twenty-one patients with spinal neuropathy underwent PCNL at our institution between January 2005 and August 2011. Their medical records were reviewed retrospectively to collect data relating to stone characteristics, treatment outcomes, and complications.
  
  
  RESULTS
  Forty-two PCNL were performed on 26 kidneys. Five patients had bilateral stones. They were 14 (66.7%) patients with spinal cord injury, 5 (23.8%) with spina bifida, and 2 (9.5%) with other neurologic abnormalities. There were 90.5% of patients with preoperative bacteriuria and 47.6% with severe scoliosis, making positioning for PCNL challenging. Complete staghorn stones occurred in 46.2% of kidneys, and 50% of stones were struvite. Only 53.8% of kidneys were stone free after the first PCNL. The success rate increased to 80.8% after the second and 88.5% after the third PCNL. Urosepsis developed in three (14.3%) patients, necessitating admission to the intensive care unit postoperatively. Six (28.6%) patients needed blood transfusion. One patient had a pneumothorax and another had a perforation of the collecting system.
  
  
  CONCLUSIONS
  Based on our experience, PCNL in patients with spinal neuropathy had a stone clearance rate comparable with that of the general population. These patients, however, needed multiple PCNLs to be stone free and had a higher incidence of complications (especially infectious).
authors: Department of Urology, Oklahoma University Health Sciences Center, Oklahoma City, OK, USA. philippe-nabbout@ouhsc.edu
authors: Philippe
authors: P
authors: Nabbout
authors: Gennady
authors: G
authors: Slobodov
authors: Adamantios M
authors: AM
authors: Mellis
authors: Daniel J
authors: DJ
authors: Culkin
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007669:Kidney Calculi / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D009403:Nephrostomy, Percutaneous / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D011859:Radiography; D013119:Spinal Cord Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*