Dataset Information

Surgical outcomes of spinal fusion for osteoporotic thoracolumbar vertebral fractures in patients with Parkinson's disease: what is the impact of Parkinson's disease on surgical outcome?

ABSTRACT:

Background

To date, there have been little published data on surgical outcomes for patients with PD with thoracolumbar OVF. We conducted a retrospective multicenter study of registry data to investigate the outcomes of fusion surgery for patients with Parkinson's disease (PD) with osteoporotic vertebral fracture (OVF) in the thoracolumbar junction.

Methods

Retrospectively registered data were collected from 27 universities and their affiliated hospitals in Japan. In total, 26 patients with PD (mean age, 76 years; 3 men and 23 women) with thoracolumbar OVF who underwent spinal fusion with a minimum of 2 years of follow-up were included (PD group). Surgical invasion, perioperative complications, radiographic sagittal alignment, mechanical failure (MF) related to instrumentation, and clinical outcomes were evaluated. A control group of 296 non-PD patients (non-PD group) matched for age, sex, distribution of surgical procedures, number of fused segments, and follow-up period were used for comparison.

Results

The PD group showed higher rates of perioperative complications (p < 0.01) and frequency of delirium than the non-PD group (p < 0.01). There were no significant differences in the degree of kyphosis correction, frequency of MF, visual analog scale of the symptoms, and improvement according to the Japanese Orthopaedic Association scoring system between the two groups. However, the PD group showed a higher proportion of non-ambulators and dependent ambulators with walkers at the final follow-up (p < 0.01).

Conclusions

A similar surgical strategy can be applicable to patients with PD with OVF in the thoracolumbar junction. However, physicians should pay extra attention to intensive perioperative care to prevent various adverse events and implement a rehabilitation regimen to regain walking ability.

SUBMITTER: Watanabe K

PROVIDER: S-EPMC6408814 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Publications

Surgical outcomes of spinal fusion for osteoporotic thoracolumbar vertebral fractures in patients with Parkinson's disease: what is the impact of Parkinson's disease on surgical outcome?

Watanabe Kei K Katsumi Keiichi K Ohashi Masayuki M Shibuya Yohei Y Izumi Tomohiro T Hirano Toru T Endo Naoto N Kaito Takashi T Yamashita Tomoya T Fujiwara Hiroyasu H Nagamoto Yukitaka Y Matsuoka Yuji Y Suzuki Hidekazu H Nishimura Hirosuke H Terai Hidetomi H Tamai Koji K Tagami Atsushi A Yamada Syuta S Adachi Shinji S Yoshii Toshitaka T Ushio Shuta S Harimaya Katsumi K Kawaguchi Kenichi K Yokoyama Nobuhiko N Oishi Hidekazu H Doi Toshiro T Kimura Atsushi A Inoue Hirokazu H Inoue Gen G Miyagi Masayuki M Saito Wataru W Nakano Atsushi A Sakai Daisuke D Nukaga Tadashi T Ikegami Shota S Shimizu Masayuki M Futatsugi Toshimasa T Ohtori Seiji S Furuya Takeo T Orita Sumihisa S Imagama Shiro S Ando Kei K Kobayashi Kazuyoshi K Kiyasu Katsuhito K Murakami Hideki H Yoshioka Katsuhito K Seki Shoji S Hongo Michio M Kakutani Kenichiro K Yurube Takashi T Aoki Yasuchika Y Oshima Masashi M Takahata Masahiko M Iwata Akira A Endo Hirooki H Abe Tetsuya T Tsukanishi Toshinori T Nakanishi Kazuyoshi K Watanabe Kota K Hikata Tomohiro T Suzuki Satoshi S Isogai Norihiro N Okada Eijiro E Funao Haruki H Ueda Seiji S Shiono Yuta Y Nojiri Kenya K Hosogane Naobumi N Ishii Ken K

BMC musculoskeletal disorders 20190309 1

<h4>Background</h4>To date, there have been little published data on surgical outcomes for patients with PD with thoracolumbar OVF. We conducted a retrospective multicenter study of registry data to investigate the outcomes of fusion surgery for patients with Parkinson's disease (PD) with osteoporotic vertebral fracture (OVF) in the thoracolumbar junction.<h4>Methods</h4>Retrospectively registered data were collected from 27 universities and their affiliated hospitals in Japan. In total, 26 pati ...[more]

PMID: 30851739

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Project description:BackgroundThoracolumbar fractures are classified into four categories according to the mechanism of injury and fracture morphology into compression fracture, burst fracture, flexion-distraction injury, and fracture dislocation. Unfortunately, the management of spinal fracture has lacked standardization given the many unanswered yet relevant questions regarding the outcome. However, management is generally divided into surgical and nonsurgical treatment such as orthosis. We aim to compare the clinical and the radiological outcomes of operative spinal fractures in patients with thoracolumbar spinal orthoses (TLSO) and patients without TLSO. Up to our knowledge, there are no similar studies comparing such management approaches in Saudi Arabia.MethodsThis is a retrospective cohort study conducted in King Saud Medical City which included patients over 18 years of age from the past 10 years who underwent spinal fixation with or without the use of orthotics and had at least 6 months follow-up. We have excluded any patients with degenerative diseases, spinal tuberculosis or spinal tumors. Our primary outcome was radiological outcomes and clinical outcomes among groups using orthotics postoperatively versus groups who didn't use orthotics. Statistical analysis was done utilizing The Statistical Package for the Social Sciences (SPSS) IBM statistical computing program version 21 was used for the statistical data analysis and the alpha significance level was considered at 0.050 level.ResultsThe patients were divided into two groups, patients given TLSO postoperatively (group A) (53.1%) and patients not given TLSO postoperatively (group B) (46.9%). Most of the patients had a burst fracture and most (86.4%) had endured a single level spine fracture. Bivariate Pearson's correlations test showed the patients mean perceived pain level [the visual analogue scale (VAS)] had correlated negatively and significantly with their emotional well-being (EM-WB) score, r=-0.132, P<0.05. Moreover, the patients self-rated pain level had correlated negatively and significantly with their satisfaction level with their comfort subscale score, r=-0.156, P<0.05. The patients mean measured kyphotic angle had correlated positively with their mean comfort level satisfaction, r=0.158, P<0.05. A non-parametric Mann-Whitney U test showed that the patients who used TLSO had perceived significantly greater general health (GH) score (mean GH score =77.44) compared to those who have not used TLSO (mean GH score =70.79), Z=2.38, P=0.02. Group A perceived significantly lower satisfaction with their social limitations (mean score =71.32) compared to group B (mean score =89.47) on average, Z=2.10, P=0.040. Group B (n=38) measured a significant decline in their pain level across the three time-point measured pain levels (P<0.001).ConclusionsOur study concludes that both groups have noticeable reductions in pain postoperatively and have shown decent results with regards to the Short Form 36 (SF-36) scores. However, further research is necessary to gain a comprehensive understanding of the varying effects of bracing versus non bracing long-term outcomes in upper thoracic and thoracolumbar fractures.

Dataset Information

Surgical outcomes of spinal fusion for osteoporotic thoracolumbar vertebral fractures in patients with Parkinson's disease: what is the impact of Parkinson's disease on surgical outcome?

Background

Methods

Results

Conclusions

Publications

Surgical outcomes of spinal fusion for osteoporotic thoracolumbar vertebral fractures in patients with Parkinson's disease: what is the impact of Parkinson's disease on surgical outcome?

Similar Datasets

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