Yokoi Katsunori, Tsujimoto Masashi, Suzuki Keisuke, Takeda Akinori, Horibe Kentaro, Yamaoka Akiko, Imai Eriko, Imai Kazunori, Katsuno Masahisa, Arahata Yutaka
Department of Neurology, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan.
Department of Neurology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Medicine (Baltimore). 2025 Jul 25;104(30):e43149. doi: 10.1097/MD.0000000000043149.
Camptocormia is a debilitating postural abnormality associated with Parkinson disease (PD), significantly impairing the daily lives of affected patients. Treatment options remain inconsistent, with lidocaine injections emerging as a potential therapy. However, the lack of standardized protocols hinders their widespread application. The present study aimed to introduce a novel method using a muscle hardness tester to objectively determine optimal injection sites.
Patients presented with postural abnormalities characterized by forward flexion, which interfered with daily activities and reduced their quality of life.
Camptocormia associated with PD was diagnosed based on clinical assessment and radiographic evaluation.
Lidocaine injections were administered to 4 patients with PD and camptocormia. Injection sites were determined based on muscle hardness measurements obtained using a muscle hardness meter. A total of 20 mL of 1% lidocaine, distributed as 2.5 mL per injection at 8 sites with the highest muscle hardness values, was administered daily for 5 consecutive days. The postural evaluation was conducted using established criteria, assessing both lower and upper flexion. Radiographic parameters, including lumbar lordosis, thoracic kyphosis, and sagittal vertical axis, were also evaluated. Radiographic assessments were performed on days 1, 5, and 1 month postinjection.
Post-treatment assessments, including spinal flexion measurements and subjective symptom evaluations, demonstrated symptomatic improvement in all cases, particularly in sagittal vertical axis, a key indicator of postural alignment.
Our method offers a reproducible approach for enhancing lidocaine injection efficacy. Given its transient effects, repeated administration was necessary. Future studies should focus on refining dosing regimens and expanding case numbers to establish long-term efficacy and optimize treatment strategies. The widespread adoption of this therapy may significantly benefit patients with PD affected by camptocormia.
camptocormia（躯干前屈症）是一种与帕金森病（PD）相关的使人衰弱的姿势异常，严重损害受影响患者的日常生活。治疗方案仍然不一致，利多卡因注射已成为一种潜在的治疗方法。然而，缺乏标准化方案阻碍了它们的广泛应用。本研究旨在引入一种使用肌肉硬度测试仪客观确定最佳注射部位的新方法。
患者表现出以向前屈曲为特征的姿势异常，这干扰了日常活动并降低了他们的生活质量。
根据临床评估和影像学评估诊断为与PD相关的躯干前屈症。
对4例患有PD和躯干前屈症的患者进行利多卡因注射。根据使用肌肉硬度计获得的肌肉硬度测量结果确定注射部位。每天在8个肌肉硬度值最高的部位各注射2.5 mL的1%利多卡因，共20 mL，连续注射5天。使用既定标准进行姿势评估，评估上下屈曲情况。还评估了包括腰椎前凸、胸椎后凸和矢状垂直轴在内的影像学参数。在注射后第1天、第5天和1个月进行影像学评估。
治疗后的评估，包括脊柱屈曲测量和主观症状评估，表明所有病例均有症状改善，特别是在矢状垂直轴方面，这是姿势对齐的关键指标。
我们的方法为提高利多卡因注射疗效提供了一种可重复的方法。鉴于其短暂的效果，有必要重复给药。未来的研究应集中在完善给药方案和扩大病例数量以确定长期疗效并优化治疗策略。这种疗法的广泛采用可能会使受躯干前屈症影响的PD患者显著受益。
