title: Low parathyroid hormone levels in patients who underwent/would undergo hemodialysis result in bone graft failure after posterolateral fusion.
abstract: METHODS
  Case series.
  
  
  OBJECTIVE
  To reveal the association between levels of parathyroid hormone (PTH) and outcome of bone fusion in patients who underwent/would undergo hemodialysis.
  
  
  BACKGROUND
  Among the different bone lesions observed in patients who underwent/would undergo hemodialysis, adynamic bone disease is regarded as a factor associated with bone graft failure because of severely reduced bone turnover. Although PTH levels reflect the pathological findings of bone lesions in patients who underwent/would undergo hemodialysis, the relationship between PTH levels and the outcome of bone fusion in patients who underwent/would undergo hemodialysis has not been investigated.
  
  
  METHODS
  Patients who underwent/would undergo hemodialysis (n = 48) with lumbar spine lesion underwent posterolateral spinal fusion with instrumentation. The outcome of bone fusion was assessed radiographically 12 months after surgery, and sensitivity and specificity were determined using preoperative PTH levels as the standard.
  
  
  RESULTS
  A significant difference in PTH levels was observed between the good fusion (mean, 235.4 pg/mL) and poor fusion (mean, 100.0 pg/mL) groups. The intersection of the sensitivity and specificity plots, generated using preoperative PTH levels, was 150 pg/mL, and the area under the receiver operating characteristic curve was 0.72.
  
  
  CONCLUSIONS
  Low PTH levels are a risk factor for bone graft failure in patients who underwent/would undergo hemodialysis. Accordingly, PTH level can be a useful predictor of the outcome of bone fusion.
  
  
  METHODS
  4.
authors.affiliation: From the Department of Orthopedic Surgery, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Kanaya
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Kato
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Murata
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Wada
authors.forename: Keiji
authors.initials: K
authors.lastname: Wada
authors.forename: Shuji
authors.initials: S
authors.lastname: Shimamoto
authors.forename: Masahiro
authors.initials: M
authors.lastname: Shiba
authors.forename: Satoshi
authors.initials: S
authors.lastname: Hatta
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy*; D008159:Lumbar Vertebrae / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D006435:Renal Dialysis; D013123:Spinal Fusion / Q000295:instrumentation*; D016896:Treatment Outcome
chemical_list: D010281:Parathyroid Hormone