title: Surgical Management for Destructive Atlantoaxial Spondyloarthropathy in Long-Term Hemodialysis Patients.
abstract: BACKGROUND
  Atlantoaxial spondyloarthropathy most often results from rheumatoid arthritis, cancer metastasis, or basilar invagination. Dialysis-related spondyloarthropathy is a rare cause of spinal deformity and cervical myelopathy at the atlantoaxial joint. We report 2 patients on long-term hemodialysis who presented with atlantoaxial spondyloarthropathy.
  
  
  METHODS
  Two patients with end-stage renal failure presented with a history of progressively worsening neck pain, motion limitation, and gait disturbance. In both patients, radiologic findings showed a bone-destroying soft tissue mass lateral to C1 and C2, compressing the spinal cord and causing atlantoaxial instability. We performed a C1 laminectomy and C12 transarticular screw fixation and biopsied the osteolytic mass. The neck pain, hand numbness, and gait disturbance improved.
  
  
  CONCLUSIONS
  Although the surgical management of these patients involves many challenges, appropriate decompression and fusion surgery is an effective treatment option.
authors: Department of Neurosurgery, Soonchunhyang University, Bucheon Hospital, Bucheon, Republic of Korea.
authors: Je Hoon
authors: JH
authors: Jeong
authors: Department of Pathology, Soonchunhyang University, Bucheon Hospital, Bucheon, Republic of Korea.
authors: Hee Kyung
authors: HK
authors: Kim
authors: Department of Neurosurgery, Soonchunhyang University, Bucheon Hospital, Bucheon, Republic of Korea. Electronic address: isbrzw@gmail.com.
authors: Soo Bin
authors: SB
authors: Im
mesh_terms: D001268:Atlanto-Axial Joint / Q000000981:diagnostic imaging / Q000601:surgery*; D003131:Combined Modality Therapy / Q000379:methods; D019299:Decompression, Surgical / Q000379:methods; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*; D013117:Spinal Cord Compression / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D013123:Spinal Fusion / Q000379:methods; D025242:Spondylarthropathies / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D016896:Treatment Outcome
keywords: Hemodialysis; Spondyloarthropathy; Surgical management