Central diabetes insipidus after staged spinal surgery.
Diabetes insipidus (DI) is described following penetrating spinal cord trauma but rarely following instrumented spinal fusion. More commonly, hyponatremia is seen following spine surgery, which may be iatrogenic, attributed to the syndrome of inappropriate antidiuretic hormone release. The authors present a case of a 57-year-old woman who underwent a planned two-stage operation for scoliotic deformity correction. On the third postoperative day, the patient developed hypernatremia (sodium levels of 157 mmol/L) and polyuria. In conjunction with endocrinology, the patient was diagnosed with central DI. The patient was treated with desmopressin acetate (DDAVP), which led to resolution of her symptoms. DDAVP was temporary and eventually weaned off. Central DI is a possible cause of hypernatremia following significant spine surgery. Correct diagnosis is paramount for rapid and appropriate treatment.
Department of Neurosurgery, Center for Spine Health, Cleveland Clinic Foundation, Cleveland, Ohio.
Benjamin P
BP
Rosenbaum
Department of Neurosurgery, Center for Spine Health, Cleveland Clinic Foundation, Cleveland, Ohio ; Department of Neurological Surgery, Case Western Reserve University School of Medicine, MetroHealth Medical Center, Cleveland, Ohio.
Michael P
MP
Steinmetz
diabetes insipidus; hypernatremia; scoliosis; spinal surgery