Posterior-Only Spinal Fusion Feasible in Parkinson's Disease
(HealthDay News) – For patients with Parkinson's disease (PD) with major spinal deformities, a posterior-only approach for spinal fusion from T2 to the sacrum is associated with good clinical and radiologic results as well as high patient satisfaction.
Anouar Bourghli, MD, from the Bordeaux Pellegrin Hospital in France, and colleagues reviewed data from 12 consecutive patients with PD treated with a posterior-only approach for spinal fusion from T2 to the sacrum. Radiographs were taken before and three months after surgery and at the last follow-up; the radiographs were assessed by an independent spine surgeon. The Scoliosis Research Society (SRS)-30 questionnaire was used to assess functionality.
The researchers report that six patients had first surgeries and six underwent revisions. Following the primary surgery, six patients underwent revisions: three for instrumentation failure, two for proximal junctional kyphosis at T1-T2, and one for epidural hematoma. All patients experienced a significant improvement in the frontal and sagittal planes after surgery. There was an improvement in the sagittal vertical axis from before the surgery to the last follow-up. Patient satisfaction as indicated on the SRS-30 questionnaire was strong, with 11 patients saying they would have the procedure done again.
"This is the first reported series of PD patients undergoing posterior spinal fusion from T2 to the sacrum for major deformities," the authors write. "This study indicates that good correction of sagittal and frontal balance enables good clinical and radiologic results that remain stable over time even when complications occur."