General
- A relatively uncommon complication of renal dialysis. It is part of the spectrum of dialysis-related amyloidosis.
Number
- middle-aged and elderly patients with chronic renal disease who have been undergoing maintenance hemodialysis
- Prevalence 5 to 25.3%
Location
- lower portion of the cervical spine
Mech
- Extensive deposition of beta-2 microglobulin (amyloid-like substance) within the spine (especially intervertebral discs).
- The disease often correlates with the duration of haemodialysis
Clinical
- Mild to moderate neck or back pain and stiffness are among the reported clinical symptoms
- Radiculopathy, myelopathy, and spinal cord compromise that may require surgical decompression and stabilization have also been reported
Radiology
Plain radiography / CT
- Non-specific but may result in sclerosis, erosion, and cyst formation along adjacent end plates in single or multiple levels. There may also be vertebral body collapse and disc space narrowing.
MRI
- Amyloid deposits are typically low signal on T1 and T2 weighted images, which is most helpful in pointing to this entity.
- The T2 signal in the disc space can occasionally be high but is not usually as high as in infectious spondylodiscitis.
Differential diagnosis
- infective discitis/spinal osteomyelitis/infectious spondylitis