Sarkiss Christopher A, Fogg Guy A, Skovrlj Branko, Cho Samuel K, Caridi John M
Icahn School of Medicine at Mount Sinai, Department of Neurosurgery, New York, USA.
Saba University School of Medicine, Saba, Bonaire, Sint Eustatius and Saba.
Clin Neurol Neurosurg. 2015 Jul;134:122-5. doi: 10.1016/j.clineuro.2015.04.022. Epub 2015 May 6.
Degenerative spondylosis and kyphoscoliosis are increasingly recognized entities in patients with Parkinson's disease. Surgical treatment with spinal fusion can be complicated due to poor bone quality and muscular dysfunction in this patient population. The goal of this paper is to investigate surgical outcomes in Parkinson's patients undergoing spine surgery.
We performed a literature review using the PubMed and Google Scholar search engines investigating "Parkinson's disease and spinal fusion surgery" from the period of 2000 to 2013. The inclusion criteria included only English articles with Parkinson's patients that underwent spinal surgery. We identified and reviewed all six articles that included ninety-five patients with Parkinson's disease who underwent spinal surgery.
A total of 95 patients with Parkinson's disease who underwent spinal fusion surgery were reviewed with average patient age of 69 and a 3:4 male to female ratio. With an average follow up of 40 months, 46 out of 73 patients (63%) were judged to have satisfactory outcomes with poor outcomes noted in the remaining 37%. These included but were not limited to pseudoarthrosis, hardware failure/pullout, development of adjacent level disease, persistent kyphosis or sagittal imbalance, and no improvement or worsening in their postoperative visual analog pain scale. There was a 45% (29/65) revision rate and a 59% (30/51) complication rate following the index procedure.
It remains unclear whether Parkinson's patients benefit from spinal fusion surgery. Further prospective research is warranted to investigate surgical outcomes in this subset of patients.
退行性脊柱病和脊柱侧凸后凸在帕金森病患者中越来越被视为常见病症。由于该患者群体骨质质量差和肌肉功能障碍，脊柱融合手术治疗可能会出现并发症。本文的目的是研究接受脊柱手术的帕金森病患者的手术效果。
我们使用PubMed和谷歌学术搜索引擎进行文献综述，检索2000年至2013年期间的“帕金森病与脊柱融合手术”。纳入标准仅包括有关接受脊柱手术的帕金森病患者的英文文章。我们识别并审阅了所有六篇文章，这些文章共纳入了95例接受脊柱手术的帕金森病患者。
共对95例接受脊柱融合手术的帕金森病患者进行了回顾，患者平均年龄为69岁，男女比例为3:4。平均随访40个月，73例患者中有46例（63%）被判定手术效果满意，其余37%效果不佳。这些情况包括但不限于假关节形成、内固定失败/拔出、相邻节段疾病的发生、持续性脊柱后凸或矢状面失衡，以及术后视觉模拟疼痛评分无改善或恶化。初次手术后的翻修率为45%（29/65），并发症发生率为59%（30/51）。
目前尚不清楚帕金森病患者是否能从脊柱融合手术中获益。有必要进行进一步的前瞻性研究来调查这一患者亚组的手术效果。
