和田　圭司
   Department   Other, Other
   Position  
Article types Original article
Language English
Peer review Peer reviewed
Title Low parathyroid hormone levels in patients who underwent/would undergo hemodialysis result in bone graft failure after posterolateral fusion.
Journal Formal name：Spine
Abbreviation：Spine (Phila Pa 1976)
ISSN code：15281159/03622436
Domestic / ForeginForegin
Volume, Issue, Page 39(4),pp.327-31
Author and coauthor Kanaya Koichi, Kato Yoshiharu, Murata Yasuaki, Wada Hiroyoshi, Wada Keiji, Shimamoto Shuji, Shiba Masahiro, Hatta Satoshi
Publication date 2014/02
Summary STUDY DESIGN: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.SUMMARY OF BACKGROUND DATA: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.CONCLUSION: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.LEVEL OF EVIDENCE:4.
DOI 10.1097/BRS.0000000000000132
PMID 24299716