Radiological Changes in Postural Deformities after Deep Brain Stimulationin Patients with Parkinson’s Disease

Abstract

BACKGROUNDː Axial postural deformities are frequent and disabling complications of Parkinson’s disease(PD). Although several studies have addressed the effects of deep brain stimulation (DBS) on the improvement ofpostural deformities in PD, there is little detailed information about it. In this paper, we report a prospective observational study evaluating the radiological changes in postural deformities after subthalamic nucleus (STN)-DBSin PD patients.METHODSː Of the 53 patients participating in the present study, 48 were completely followed up prospectivelyfor 12 months after surgery. We assessed the coronal Cobb angulation representing scoliosis, the thoracic andlumbar sagittal Cobb angulation representing thoracic kyphosis and lumbar lordosis, and forward tilt angulation.Anteroposterior and lateral X-rays of the whole spine in the standing position were taken preoperatively and at 6and 12 months postoperatively.RESULTSː The number of PD patients with scoliosis defined as over 10 degrees in terms of the coronal Cobbangles was decreased after STN-DBS, 25/48 (52.1%) at 6 months and 23/48 (47.9%) at 12 months, while preoperatively, 30/48 (62.5%) patients had Cobb angles of over 10. The mean coronal Cobb angle was significantly improved after DBS (14.2 ± 12.1 preoperatively, 12.6 ± 12.6 at 6 months after DBS, and 11.4 ± 11.1 at 12 monthsafter DBS). On the other hand, there was no statistically significant improvement in thoracic kyphosis angulation,lumbar lordosis angulation, and forward tilt angulation after STN-DBS.CONCLUSIONSː The coronal Cobb angles indicated that scoliosis was significantly improved after STN-DBS.