The severity of cervical spine abnormalities was evaluated in 99 non-diabetic hemodialysis patients on the basis of plain X-ray examinations and graded according whether a geode of the end-plate was present, the degree of narrowing of the disc space and where there were bone cysts. The grades were defined as follows: grade 0 (G0): no abnormal findings, grade 1 (G1): a geode of the end-plate without narrowing of the disc space, grade 2 (G2): a geode of the end-plate with marked narrowing of the disc space, and grade 3 (G3): severely destroyed vertebral body with bone cyst, with or without disappearance of the disc space.
Fifty patients (50.5%) had normally appeaing cervical spines with or without osteophytes, while 49 patients (49.5%) were found to have cervical spine lesions, with 25 (25.3%) of them graded G1, 18 (18.2%) G2, and 6 (6.1%) G3. G2 and G3 were considered to represent destructive spondylarthropathy. The lower cervical discs, below C5, were found to be most susceptible to destruction. The present age and age at the start of HD of G3 patients, 70±5 (SE) years and 61±5 years, respectively, were the highest among the groups, but there was no difference among them in HD duration. A synthetic membrane dialyzer was more frequently used in patients with G0 and G1 lesions, than in those with G2 and G3 lesions (p<0.05). None of the G3 patients were treated using synthetic membranes. There were no differences between the groups in plasma β₂-microglobulin, parathyroid hormone or other biochemical parameters. The results of this study suggest that plain X-ray examinations are useful in evaluating dialysis-related cervical spine lesions, and that HD with a synthetic membrane might prevent the progression of these lesions.