Sato Masashi, Sainoh Takeshi, Orita Sumihisa, Yamauchi Kazuyo, Aoki Yasuchika, Ishikawa Tetsuhiro, Miyagi Masayuki, Kamoda Hiroto, Suzuki Miyako, Kubota Gou, Sakuma Yoshihiro, Inage Kazuhide, Oikawa Yasuhiro, Nakamura Junichi, Takaso Masashi, Inoue Gen, Toyone Tomoaki, Takahashi Kazuhisa, Ohtori Seiji
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
Case Rep Orthop. 2013;2013:140916. doi: 10.1155/2013/140916. Epub 2013 Sep 2.
Introduction. Spinal scoliosis and kyphosis in elderly people sometimes cause severe low back pain. Surgical methods such as osteotomy are useful for correcting the deformity. However, complications during and after surgery are associated with the osteotomy procedure. In particular, it is difficult to manage deformity correction surgery for patients with Parkinson's disease. Here, we present two cases of combined anterior and posterior surgery for deformity in patients with adult scoliosis and kyphosis due to Parkinson's disease. Case Presentation. Two 70-year-old women had spinal scoliosis and kyphosis due to Parkinson's disease. They had severe low back pain, and conservative treatment was not effective for the pain. Surgery was planned to correct the deformity in both patients. We performed combined posterior and anterior correction surgery. At first, posterior fusions were performed from T4 to the ilium using pedicle screws. Next, cages and autograft from the iliac crest were used in anterior lumbar surgery. The patients became symptom free after surgery. Bony fusion was observed 12 months after surgery. Conclusions. Combined posterior and anterior fusion surgery is effective for patients who show scoliosis and kyphosis deformity, and symptomatic low back pain due to Parkinson's disease.
引言。老年人的脊柱侧弯和后凸有时会导致严重的腰痛。诸如截骨术等手术方法对于矫正畸形很有用。然而，手术期间及术后的并发症与截骨手术相关。特别是，帕金森病患者的畸形矫正手术很难处理。在此，我们展示两例因帕金森病导致成人脊柱侧弯和后凸畸形患者接受前后联合手术的病例。病例报告。两名70岁女性因帕金森病患有脊柱侧弯和后凸。她们有严重的腰痛，保守治疗对疼痛无效。计划对两名患者进行手术矫正畸形。我们实施了前后联合矫正手术。首先，使用椎弓根螺钉从T4至髂骨进行后路融合。接下来，在腰椎前路手术中使用椎间融合器和取自髂嵴的自体骨移植。患者术后症状消失。术后12个月观察到骨融合。结论。前后联合融合手术对于表现出脊柱侧弯和后凸畸形以及因帕金森病导致有症状性腰痛的患者有效。
