BMC Musculoskeletal Disorders (Mar 2019)

Surgical outcomes of spinal fusion for osteoporotic thoracolumbar vertebral fractures in patients with Parkinson’s disease: what is the impact of Parkinson’s disease on surgical outcome?

  • Kei Watanabe,
  • Keiichi Katsumi,
  • Masayuki Ohashi,
  • Yohei Shibuya,
  • Tomohiro Izumi,
  • Toru Hirano,
  • Naoto Endo,
  • Takashi Kaito,
  • Tomoya Yamashita,
  • Hiroyasu Fujiwara,
  • Yukitaka Nagamoto,
  • Yuji Matsuoka,
  • Hidekazu Suzuki,
  • Hirosuke Nishimura,
  • Hidetomi Terai,
  • Koji Tamai,
  • Atsushi Tagami,
  • Syuta Yamada,
  • Shinji Adachi,
  • Toshitaka Yoshii,
  • Shuta Ushio,
  • Katsumi Harimaya,
  • Kenichi Kawaguchi,
  • Nobuhiko Yokoyama,
  • Hidekazu Oishi,
  • Toshiro Doi,
  • Atsushi Kimura,
  • Hirokazu Inoue,
  • Gen Inoue,
  • Masayuki Miyagi,
  • Wataru Saito,
  • Atsushi Nakano,
  • Daisuke Sakai,
  • Tadashi Nukaga,
  • Shota Ikegami,
  • Masayuki Shimizu,
  • Toshimasa Futatsugi,
  • Seiji Ohtori,
  • Takeo Furuya,
  • Sumihisa Orita,
  • Shiro Imagama,
  • Kei Ando,
  • Kazuyoshi Kobayashi,
  • Katsuhito Kiyasu,
  • Hideki Murakami,
  • Katsuhito Yoshioka,
  • Shoji Seki,
  • Michio Hongo,
  • Kenichiro Kakutani,
  • Takashi Yurube,
  • Yasuchika Aoki,
  • Masashi Oshima,
  • Masahiko Takahata,
  • Akira Iwata,
  • Hirooki Endo,
  • Tetsuya Abe,
  • Toshinori Tsukanishi,
  • Kazuyoshi Nakanishi,
  • Kota Watanabe,
  • Tomohiro Hikata,
  • Satoshi Suzuki,
  • Norihiro Isogai,
  • Eijiro Okada,
  • Haruki Funao,
  • Seiji Ueda,
  • Yuta Shiono,
  • Kenya Nojiri,
  • Naobumi Hosogane,
  • Ken Ishii

DOI
https://doi.org/10.1186/s12891-019-2473-8
Journal volume & issue
Vol. 20, no. 1
pp. 1 – 9

Abstract

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Abstract Background To date, there have been little published data on surgical outcomes for patients with PD with thoracolumbar OVF. We conducted a retrospective multicenter study of registry data to investigate the outcomes of fusion surgery for patients with Parkinson’s disease (PD) with osteoporotic vertebral fracture (OVF) in the thoracolumbar junction. Methods Retrospectively registered data were collected from 27 universities and their affiliated hospitals in Japan. In total, 26 patients with PD (mean age, 76 years; 3 men and 23 women) with thoracolumbar OVF who underwent spinal fusion with a minimum of 2 years of follow-up were included (PD group). Surgical invasion, perioperative complications, radiographic sagittal alignment, mechanical failure (MF) related to instrumentation, and clinical outcomes were evaluated. A control group of 296 non-PD patients (non-PD group) matched for age, sex, distribution of surgical procedures, number of fused segments, and follow-up period were used for comparison. Results The PD group showed higher rates of perioperative complications (p < 0.01) and frequency of delirium than the non-PD group (p < 0.01). There were no significant differences in the degree of kyphosis correction, frequency of MF, visual analog scale of the symptoms, and improvement according to the Japanese Orthopaedic Association scoring system between the two groups. However, the PD group showed a higher proportion of non-ambulators and dependent ambulators with walkers at the final follow-up (p < 0.01). Conclusions A similar surgical strategy can be applicable to patients with PD with OVF in the thoracolumbar junction. However, physicians should pay extra attention to intensive perioperative care to prevent various adverse events and implement a rehabilitation regimen to regain walking ability.

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