Objective: To evaluate the efficacy and feasibility of percutaneous
nephrolithotomy (PCNL) in patients with spinal deformities.
Methods: We retrospectively reviewed the clinical data of 8
patients with spinal deformities underwent PCNL from March
2004 to May 2010 in our hospital. Preoperative investigation
of the respiratory function and evaluation of anatomy by
intravenous pyelography and CT spiral scan were performed in
all patients. Demographic data, number of accesses, location of
accesses, hemoglobin values, and complications were recorded.
Results: Of these 8 patients, the male to female ratio was 3:1
and the mean age was 39.5 years (range, 22-48 years). Among
them, 5 patients required a single standard tract, while 3 needed
a single standard tract and a micro-tract. A double-J catheter
was inserted in all patients and it was removed 4 weeks after the
operation. Of them, no patient encountered septic shock. One
patient needed blood transfusion. The complete stone clearance
rate was 75% (6/8). Two patients required extracorporeal shock
wave lithotripsy (SWL). During the 3-month follow-up, the
overall stone-free rate was 87.5% (7/8).
Conclusions: PCNL in patients with spinal deformities is
challenging. Accurate preoperative evaluation of the anatomy
and respiratory function and a precise preoperative planning
are compulsory. Prone position may offer a wider space for
percutaneous access. The complete stone clearance rate is
acceptable. Combination therapy with SWL after PCNL
improves stone-free rate.