von Coelln Rainer, Raible Armin, Gasser Thomas, Asmus Friedrich
Department for Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany.
Mov Disord. 2008 Apr 30;23(6):889-92. doi: 10.1002/mds.21967.
Camptocormia is characterized by an abnormal posture of the trunk with pronounced flexion of the thoraco-lumbar spine during standing and walking, which abates in a supine position. Treatment options for camptocormia are limited and mostly futile. Here, we report on the ultrasound-guided ventral injection of botulinum toxin A (BTX) into deep portions of the iliopsoas muscle in four parkinsonian patients with camptocormia as chief complaint. Using this novel and safe application technique, all patients received 500-1,500 MU of BTX per side in 4-6 month intervals. Treatment was generally well tolerated. At the highest dose, all patients complained of mild weakness of hip flexion. Standardized physical exam at follow-up visits, as well as self-assessment of patients, failed to show a relevant and lasting improvement of posture. In conclusion, injection of BTX into the iliopsoas does not appear to be a promising approach for the treatment of parkinsonism-associated camptocormia.
弯腰驼背的特征是在站立和行走时躯干姿势异常，胸腰椎明显前屈，而仰卧位时这种情况会减轻。弯腰驼背的治疗选择有限，且大多无效。在此，我们报告了4例以弯腰驼背为主要症状的帕金森病患者，在超声引导下向髂腰肌深部注射A型肉毒杆菌毒素（BTX）的情况。采用这种新颖且安全的应用技术，所有患者每侧接受500 - 1500 MU的BTX，间隔4 - 6个月注射一次。治疗总体耐受性良好。在最高剂量时，所有患者均主诉髋部屈曲轻度无力。随访时的标准化体格检查以及患者的自我评估均未显示姿势有显著且持久的改善。总之，向髂腰肌注射BTX似乎不是治疗帕金森病相关弯腰驼背的有效方法。
