Abstract
BackgroundParkinson’s disease (PD) has been found to increase the risk of postoperative complications in patients with adult spinal deformity (ASD). However, few studies have investigated this by directly comparing patients with PD and those without PD.MethodsIn this multicenter retrospective cohort study, we reviewed all surgically treated ASD patients with at least 2 years of follow-up. Among them, 27 had PD (PD+ group). Clinical data were collected on early and late postoperative complications as well as any revision surgery. Radiographic parameters were evaluated before and immediately after surgery and at final follow-up, including sagittal vertical axis (SVA), thoracic kyphosis, lumbar lordosis, sacral slope, and pelvic tilt. We compared the surgical outcomes and radiographic parameters of PD patients with those of non-PD patients.ResultsFor early complications, the PD+ group demonstrated a higher rate of delirium than the PD− group. In terms of late complications, the rate of non-union was significantly higher in the PD+ group. Rates of rod failure and revision surgery due to mechanical complications also tended to be higher, but not significantly, in the PD+ group (p = 0.17, p = 0.13, respectively). SVA at final follow-up and loss of correction in SVA were significantly higher in the PD+ group.ConclusionExtra attention should be paid to perioperative complications, especially delirium, in PD patients undergoing surgery for ASD. Furthermore, loss of correction and rate of non-union were greater in these patients.
Highlights
Parkinson’s disease (PD) has been found to increase the risk of postoperative complications in patients with adult spinal deformity (ASD)
There was no significant difference between the two groups with respect to age, sex, Body mass index (BMI), or bone mineral density (BMD)
The number of fixed spinal levels was significantly higher in the PD+ group than in the PD− group (9.3 ± 2.6 vs 7.8 ± 1.9, p = 0.006), and the rates of three-column osteotomy tended to be higher in the PD+ group (63.0% vs 48.5%, p = 0.14)
Summary
Parkinson’s disease (PD) has been found to increase the risk of postoperative complications in patients with adult spinal deformity (ASD). Studies have reported that these various postural abnormalities can increase susceptibility to development of rigid spinal deformities [2, 3] and that patients with PD develop adult spinal deformity (ASD) more frequently than the general population in the same age group [6]. Recent studies have found that ASD negatively affects health-related quality of life [7, 8]. Surgical treatment has been shown to provide better health-related quality of life outcomes than non-surgical treatment, especially in patients with severe deformity [9]. Late complications include junctional kyphosis, rod fractures, and non-union, which usually develop more than 1 month after surgery and are mainly caused by continuous mechanical stress
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