Introduction

Deformity associating coronal and sagittal malalignment can severely impair quality of life in Parkinson's disease (PD). Realignment using patient-specific rods (PSRs) is useful for achieving alignment goals.

Methods

This was a retrospective single-center analysis of a prospectively maintained database of all PD patients who underwent surgery between January 2013 and January 2017. Clinical evaluation, preoperatively and at 1 year's follow-up, used the Oswestry Disability Index (ODI). Radiological evaluation used systematic preoperative and 1-year postoperative full-spine radiographs.

Results

Twelve patients were included: 6 female, 6 male; mean age, 68.4 years. Mean follow-up was 40.8 months [range 12–70]. On average, 14 levels were fused [range 10–18]. Unplanned revision surgery was necessary for 8 patients at a mean 15.625 months after index surgery. Mean preoperative ODI score was 64% preoperatively [range 56–70] versus 52% [range 28–64] at 1 year's follow-up (P = 0.004). Lumbar lordosis improved significantly, from −16.7° preoperatively to −41.4° at 1 year (P = 0.006). Pelvic tilt was the least effectively corrected parameter, with a mean preoperative value of 31.6° vs. 27.8° at 1 year (P = 0.19). Mean preoperative sagittal vertical axis was 149.7 mm versus 73.6 mm at 1 year (P = 0.013). Mean preoperative coronal tilt was 68.2 mm versus 22.9 mm at 1 year (P = 0.007).

Conclusion

Parkinson's disease is a degenerative disease frequently associated with major spine malalignment. The severity of the postural disorders in these patients needs special precautions to avoid complications.

中文翻译：

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帕金森病患者脊柱畸形手术：我们缺少什么？

介绍

与冠状和矢状位排列不齐相关的畸形会严重影响帕金森病 (PD) 的生活质量。使用特定于患者的棒 (PSR) 进行重新对准有助于实现对准目标。

方法

这是对 2013 年 1 月至 2017 年 1 月期间接受手术的所有 PD 患者的前瞻性维护数据库的回顾性单中心分析。在术前和 1 年随访时使用 Oswestry 残疾指数 (ODI) 进行临床评估。放射学评估使用系统的术前和术后 1 年的全脊柱 X 光片。

结果

包括12名患者：6名女性，6名男性；平均年龄 68.4 岁。平均随访时间为 40.8 个月 [范围 12-70]。平均而言，融合了 14 个级别 [范围 10-18]。8 名患者在初次手术后平均 15.625 个月需要进行计划外翻修手术。平均术前 ODI 评分在术前为 64% [范围 56-70]，而在 1 年的随访中为 52% [范围 28-64] ( P  =  0.004)。腰椎前凸显着改善，从术前的 -16.7° 到 1 年的 -41.4°（P  =  0.006）。骨盆倾斜度是矫正效果最差的参数，术前平均值为 31.6°，而 1 年时为 27.8°（P  =  0.19）。平均术前矢状纵轴为 149.7  mm，而 1 年时为 73.6  mm（P  =  0.013）。平均术前冠状倾斜为 68.2 毫米，而 1 年时为 22.9 毫米（P  =  0.007）。

结论

帕金森病是一种退行性疾病，通常与严重的脊柱错位有关。这些患者体位障碍的严重程度需要特殊预防措施以避免并发症。