389 Spinal Fusion in Parkinsons Disease – Surgery, Radiography and Complications

Abstract

Abstract Aim To understand the effectiveness of spinal fusion in PD, this review will focus on the surgical and radiological outcomes of this specific patient group using spinal fusion, within the background of pre- and post-operative complications. Method This literature review was conducted using PubMed, Embase and Medline databases. The selection criteria included studies with patients who are undergoing primary spinal fusion surgery, excluding any other neuromuscular disorders. We identified and reviewed twenty-eight studies in which spinal fusion was conducted in PD patients, encompassing clinical, radiographic outcomes and perioperative complications. Results A total of 363 patients with PD who underwent primary spinal fusion surgery were reviewed with an average age of 64 and a 3:4 male to female ratio. With average follow up at 52 months, 69 out of 97 patients were judged to have a satisfactory outcome with the remaining 29% reporting worsening Visual Analog Score (VAS) post-surgically. 84 out of 121 patients showed an improved Sagittal Vertical Axis (SVA) at follow up. 134 patients out of 145 displayed greater overall total complications when compared to non-PD patients. Conclusions Spinal fusion within PD patients has shown to be of benefit clinically with radiographic measures showing improvement post-surgically which is sustained at follow up. However, what limits its efficacy is the development of complications in this complex patient group. Continued prospective research is required and perhaps the advent of minimally invasive approaches may further benefit these patients and minimise complications.