Ye Xiaoyun, Lou Danning, Ding Xueping, Xie Chaoyan, Gao Jixiang, Lou Yuting, Cen Zhidong, Xiao Yuxiang, Miao Qianzhuang, Xie Fei, Zheng Xiaosheng, Wu Jianxin, Li Fangcai, Luo Wei
Department of Neurology, Second Affiliated Hospital, School of Medicine, Zhejiang University, 88 Jiefang Road, Hangzhou, 310009, China.
Department of Neurology, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.
Eur Spine J. 2017 Jul;26(7):1862-1870. doi: 10.1007/s00586-017-5018-6. Epub 2017 Mar 9.
Postural deformities in the coronal plane were frequent and disabling complications of PD, which reduces the quality of life of patients. This study aimed to garner greater attention to the Parkinson disease (PD)-related postural trunk deviations in the coronal plane by exploring a method for diagnosis because of the lack of any uniform diagnostic criteria and epidemiological studies. It also aimed to provide correlation data in the Chinese PD patients.
In this cross-sectional study, 503 consecutive outpatients with PD were enrolled who underwent standardized clinical evaluation. The study recruited 83 PD patients diagnosed with Pisa syndrome (PS). Scoliosis and coronal imbalance were diagnosed accurately by radiographic data. The PD patients were compared based on the Cobb angle and coronal balance for several demographic and clinical variables.
PD patients with PS had a prevalence of 16.5%. The prevalence of coronal imbalance and scoliosis was 10.34 and 7.75%, respectively. PD patients with PS were older and had a more severe disease, significantly longer disease duration and treatment duration, and reduced quality of life. The most important finding was that the different morphology of the spinal level had an effect on the severity of coronal balance or Cobb angle.
The present study indicated that the postural deformities in the coronal plane were related to the morphology of the spinal level, especially the position of the Cobb angle. To benefit the PD patients with PS, the full-length standing spine radiographs should be performed as early as possible.
冠状面姿势畸形是帕金森病(PD)常见且致残的并发症,会降低患者的生活质量。由于缺乏统一的诊断标准和流行病学研究,本研究旨在通过探索一种诊断方法,以引起对PD相关冠状面姿势性躯干偏差的更多关注。本研究还旨在提供中国PD患者的相关数据。
在这项横断面研究中,连续纳入503例接受标准化临床评估的门诊PD患者。该研究招募了83例被诊断为 Pisa综合征(PS)的PD患者。通过影像学数据准确诊断脊柱侧弯和冠状面失衡。根据Cobb角和冠状面平衡,对PD患者的几个人口统计学和临床变量进行比较。
PS的PD患者患病率为16.5%。冠状面失衡和脊柱侧弯的患病率分别为10.34%和7.75%。患有PS的PD患者年龄更大,疾病更严重,病程和治疗时间显著更长,生活质量更低。最重要的发现是,脊柱节段的不同形态对冠状面平衡或Cobb角的严重程度有影响。
本研究表明,冠状面姿势畸形与脊柱节段的形态有关,尤其是Cobb角的位置。为了使患有PS的PD患者受益,应尽早进行全长站立位脊柱X线片检查。